Organization
GREENWOOD LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS STOUT (MANAGER)
(501) 747-1343
Entity
Organization
Contact information
Practice address
8907 KANIS RD STE 401, LITTLE ROCK, AR 72205-6400
(501) 747-1343
(501) 747-2203
Mailing address
PO BOX 56440, LITTLE ROCK, AR 72215-6440
(501) 747-1343
(501) 747-2203
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL158884
BUSINESS LICENSE
AR
Enumeration date
10/17/2019
Last updated
03/17/2020
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