Organization
PHOENIX LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERIN C THOMAS (HR)
(501) 227-7688
Entity
Organization
Contact information
Practice address
11908 KANIS RD STE G8, LITTLE ROCK, AR 72211-3773
(501) 228-5556
(501) 228-5558
Mailing address
11908 KANIS RD STE G8, LITTLE ROCK, AR 72211-3773
(501) 228-5556
(501) 228-5558
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
BL155832
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66366858-SLS
STATE SALES TAX ID
AR
01
—
BL155832
BUSINESS LICENSE
AR
Enumeration date
11/02/2017
Last updated
11/02/2017
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