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General NPI Number Information
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NPI Number | 1811457492
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Entity Type | Organization
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Legal Business Name | FIRST LAB, LLC
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 3124 WILLOW CREEK RD
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City | PRESCOTT
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State | AZ
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Zip | 86301-6610
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Country | US
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Telephone | 888-888-8888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6307
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-1307
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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 | REVENUE CYCLE MANAGER
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Name | JENNIFER MCCOSH
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Credential |
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Telephone | 801-471-9975
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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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