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NPI 1750045969

NPI 1750045969 : BIOLAB SCIENCES, INC. : SCOTTSDALE, AZ

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General NPI Number Information
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    NPI Number           |    1750045969
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    Entity Type          |    Organization 
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    Legal Business Name  |    BIOLAB SCIENCES, INC. 
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Dates
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    Enumeration Date     |    10/25/2021
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    Last Update Date     |    10/25/2021
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Provider Practice Location Address
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    Address Line         |    13825 N. NORTHSITE BLVD. SUITE 101
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85260
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    Country              |    US
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    Telephone            |    602-830-5122
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    Fax                  |    480-546-4524
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Provider Business Mailing Address
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    Address Line         |    13825 N. NORTHSITE BLVD. SUITE 101
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    City                 |    SCOTTSDALE
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    State                |    AZ
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    Zip                  |    85260
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    Country              |    US
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    Telephone            |    602-830-5122
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    Fax                  |    480-546-4524
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Authorized Official
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    Title or Position    |    PIOR AUTHORIZATION MANAGER
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    Name                 |     ANN MARIE KIRSLING 
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    Credential           |    
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    Telephone            |    602-830-5122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    291U00000X
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    Taxonomy Name        |    Clinical Medical Laboratory
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    License Number       |    
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    License Number State |    
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