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General NPI Number Information
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NPI Number | 1780271130
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Entity Type | Organization
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Legal Business Name | FREEDOM LABS & DIAGNOSTICS LLC
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 2965 S JONES BLVD STE D2
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City | LAS VEGAS
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State | NV
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Zip | 89146-5629
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Country | US
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Telephone | 725-500-0262
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Fax |
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Provider Business Mailing Address
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Address Line | 2965 S JONES BLVD STE D2
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City | LAS VEGAS
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State | NV
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Zip | 89146-5629
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICK K SAGA
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Credential |
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Telephone | 702-722-7177
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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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