Provider Demographics
NPI:1902587900
Name:LAB ASSIST PRO, LLC.
Entity Type:Organization
Organization Name:LAB ASSIST PRO, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-736-0435
Mailing Address - Street 1:145 ABENBERG CT
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-7135
Mailing Address - Country:US
Mailing Address - Phone:414-736-0435
Mailing Address - Fax:
Practice Address - Street 1:1572 HIGHWAY 85 N STE 330
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7730
Practice Address - Country:US
Practice Address - Phone:414-736-0435
Practice Address - Fax:470-517-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center