Organization
C19 LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW TAYLOR BRIGHT PHD (PRESIDENT)
(609) 977-0604
Entity
Organization
Contact information
Practice address
881 CORPORATE DR, LEXINGTON, KY 40503-2748
(609) 977-0604
Mailing address
838 E HIGH ST # 202, LEXINGTON, KY 40502-2107
(609) 977-0604
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010936
—
OH
05
—
7100870290
—
KY
Enumeration date
10/06/2020
Last updated
08/01/2023
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