Provider Demographics
NPI:1962921445
Name:CABOT LAB LLC
Entity type:Organization
Organization Name:CABOT LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAISON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-222-3870
Mailing Address - Street 1:833 E ARAPAHO RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2245
Mailing Address - Country:US
Mailing Address - Phone:214-382-9960
Mailing Address - Fax:972-637-8660
Practice Address - Street 1:833 E ARAPAHO RD STE 105
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2245
Practice Address - Country:US
Practice Address - Phone:214-382-9960
Practice Address - Fax:972-637-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37D2057496291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory