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General NPI Number Information
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NPI Number | 1811655970
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Entity Type | Organization
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Legal Business Name | UTOPIAN LAB SOLUTIONS LLC.
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 4016 SOUTH THIRD STREET #1016
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-3225
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Country | US
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Telephone | 904-322-4351
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Fax | 866-321-0366
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Provider Business Mailing Address
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Address Line | 5959 FORT CAROLINE RD APT 1702
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City | JACKSONVILLE
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State | FL
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Zip | 32277-1842
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Country | US
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Telephone | 904-322-4351
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Fax | 866-321-0366
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Authorized Official
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Title or Position | OWNER
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Name | TAMMY WOODS
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Credential | LPN
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Telephone | 904-322-4351
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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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