Provider Demographics
NPI:1861988982
Name:BEST LAB
Entity type:Organization
Organization Name:BEST LAB
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEPULVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:CHEMIST
Authorized Official - Phone:888-449-7799
Mailing Address - Street 1:HIDALGO 248 A
Mailing Address - Street 2:SAN ANTONIO TLAYACAPAN
Mailing Address - City:CHAPALA
Mailing Address - State:JALISCO
Mailing Address - Zip Code:45906
Mailing Address - Country:MX
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HIDALGO 248 A
Practice Address - Street 2:SAN ANTONIO TLAYACAPAN
Practice Address - City:CHAPALA
Practice Address - State:JALISCO
Practice Address - Zip Code:45906
Practice Address - Country:MX
Practice Address - Phone:888-449-7799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZCP4876548246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4876548OtherGOVERMENT