Organization
I-LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD JIMMY BROCKMAN (PRESIDENT)
(720) 862-6279
Entity
Organization
Contact information
Practice address
9695 S YOSEMITE ST, LONE TREE, CO 80124-2888
(720) 862-6279
Mailing address
1820 E 17TH ST, SUITE 160, IDAHO FALLS, ID 83404-6469
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
06D1088640
CO
Other
Enumeration date
08/05/2008
Last updated
02/15/2009
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