MEDICARE: LABNET INC

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	:	1932215936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABNET INC

Provider Business Mailing Address
First Line	:	13236 N 7TH ST STE 4
Second Line	:	PO BX 245
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5343
Country	:	US
Telephone Number	:	602-923-0605
Fax Number	:	602-866-1480

Provider Business Practice Location Address
First Line	:	3515 W UNION HILLS #111
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-2429
Country	:	US
Telephone Number	:	602-923-0605
Fax Number	:	602-866-1480

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. MICHAEL PICCIRILLO
Credential	:	M.T. AMT
Telephone Number	:	602-323-7000

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	05/19/2010

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