Organization
WELLCARE LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY BRYAN SMITH (AUTHORIZED PERSON)
(228) 206-7355
Entity
Organization
Contact information
Practice address
1270 28TH ST, GULFPORT, MS 39501-6205
(228) 206-7355
(228) 284-5304
Mailing address
1270 28TH ST, GULFPORT, MS 39501-6205
(228) 206-7355
(228) 284-5304
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
10/06/2020
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