Provider Demographics
NPI:1548010259
Name:PROLAB SOLUTIONS LLC
Entity type:Organization
Organization Name:PROLAB SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-707-3938
Mailing Address - Street 1:4130 SALISBURY RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8050
Mailing Address - Country:US
Mailing Address - Phone:888-466-4622
Mailing Address - Fax:888-466-4622
Practice Address - Street 1:4130 SALISBURY RD STE 2200
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8050
Practice Address - Country:US
Practice Address - Phone:888-466-4622
Practice Address - Fax:888-466-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty