Provider Demographics
NPI:1730874348
Name:RE-SET LAB & DIAGNOSTICS LLC
Entity type:Organization
Organization Name:RE-SET LAB & DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-277-3377
Mailing Address - Street 1:1301 YORK RD STE 800 LT8
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6011
Mailing Address - Country:US
Mailing Address - Phone:833-277-3377
Mailing Address - Fax:
Practice Address - Street 1:1301 YORK RD STE 800 LT8
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6011
Practice Address - Country:US
Practice Address - Phone:833-277-3377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory