Organization
GRAVITAS LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRY DOVE PITTMAN (CEO)
(317) 701-4191
Entity
Organization
Contact information
Practice address
11903 E WELLAND ST STE F, INDIANAPOLIS, IN 46229-3911
(800) 537-3381
Mailing address
1126 INDIAN TRL, CARMEL, IN 46032-2804
(317) 701-4191
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
302F00000X
Exclusive Provider Organization
—
—
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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