Provider Demographics
NPI:1134092471
Name:850 LABS TO GO LLC
Entity type:Organization
Organization Name:850 LABS TO GO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CFO, DIRECTOR, COLLECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSIDY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BACON
Authorized Official - Suffix:
Authorized Official - Credentials:CPT, CCMA
Authorized Official - Phone:850-630-2667
Mailing Address - Street 1:6954 W HIGHWAY 98 APT 102
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32407-5459
Mailing Address - Country:US
Mailing Address - Phone:850-630-2667
Mailing Address - Fax:754-339-0030
Practice Address - Street 1:6954 W HIGHWAY 98 APT 2-102
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-5433
Practice Address - Country:US
Practice Address - Phone:850-630-2667
Practice Address - Fax:754-339-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physicianGroup - Single Specialty