Organization
VITAS LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY TAYLOR (OWNER)
(479) 353-5180
Entity
Organization
Contact information
Practice address
702 7TH ST, BRUNSWICK, GA 31520-3249
(479) 434-5643
Mailing address
PO BOX 23189, BARLING, AR 72923-0189
(479) 434-5643
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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