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General NPI Number Information
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NPI Number | 1932461738
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Entity Type | Organization
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Legal Business Name | LABEXPRESS MEDILAB LLC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 2720 OLD ROSEBUD RD 2ND FLOOR, STE 280
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City | LEXINGTON
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State | KY
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Zip | 40509-8004
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Country | US
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Telephone | 877-294-1621
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Fax | 866-897-2926
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Provider Business Mailing Address
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Address Line | 2720 OLD ROSEBUD RD 2ND FLOOR, STE 280
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City | LEXINGTON
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State | KY
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Zip | 40509-8004
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Country | US
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Telephone | 877-294-1621
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Fax | 866-897-2926
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Authorized Official
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Title or Position | OWNER
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Name | RON COBURN
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Credential |
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Telephone | 859-421-9596
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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 | 200335
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License Number State | KY
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