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General NPI Number Information
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NPI Number | 1942809934
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Entity Type | Organization
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Legal Business Name | LABMD2, INC
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 20804 EDDS LN
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City | POTOMAC FALLS
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State | VA
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Zip | 20165-7904
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Country | US
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Telephone | 703-444-6633
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Fax | 703-444-6632
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Provider Business Mailing Address
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Address Line | 20804 EDDS LN
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City | POTOMAC FALLS
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State | VA
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Zip | 20165-7904
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Country | US
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Telephone | 703-444-6633
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL DAUGHERTY
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Credential |
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Telephone | 703-444-6633
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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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