MEDICARE: AT YOUR DOOR LAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1881532943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT YOUR DOOR LAB LLC

Provider Business Mailing Address
First Line	:	10708 BALLANTRAYE DR STE 204
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-4701
Country	:	US
Telephone Number	:	540-602-5067
Fax Number	:

Provider Business Practice Location Address
First Line	:	10708 BALLANTRAYE DR STE 204
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-4701
Country	:	US
Telephone Number	:	540-602-5067
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FRANCISCO LISANDRO CASTILLO MORENO
Credential	:
Telephone Number	:	540-602-5067

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “AT YOUR DOOR LAB LLC ” Practice Location

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