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General NPI Number Information
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NPI Number | 1851198790
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Entity Type | Organization
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Legal Business Name | JUST A STIK AWAY LAB SERVICES LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1460 ANN ST STE 4
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City | MONTGOMERY
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State | AL
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Zip | 36107-3103
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Country | US
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Telephone | 334-424-7508
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 ANN ST STE 4
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City | MONTGOMERY
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State | AL
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Zip | 36107-3103
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Country | US
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Telephone | 334-721-7222
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Fax | 334-721-7233
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | MARQUITA A NORMAN
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Credential | PHLEBOTOMY TECH
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Telephone | 334-721-7222
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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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