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General NPI Number Information
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NPI Number | 1740780014
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Entity Type | Organization
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Legal Business Name | LABS ON THE GO, LLC
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 303 COLES CREEK DR
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City | CARENCRO
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State | LA
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Zip | 70520-5791
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Country | US
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Telephone | 337-202-5330
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Fax | 337-565-2553
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Provider Business Mailing Address
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Address Line | 303 COLES CREEK DR
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City | CARENCRO
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State | LA
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Zip | 70520-5791
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Country | US
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Telephone | 337-298-9496
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Fax | 337-565-2553
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Authorized Official
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Title or Position | OWNER/PHLEBOTOMIST
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Name | JOSHUA STEPHEN DUHON
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Credential | NCPT
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Telephone | 337-202-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 664449
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License Number State | LA
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