Organization
MY CHEM LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHA D LASANE (OWNER)
(352) 571-3148
Entity
Organization
Contact information
Practice address
602 JACKSON ST, WILDWOOD, FL 34785-3301
(352) 571-3148
Mailing address
PO BOX 572, WILDWOOD, FL 34785-0572
(352) 571-3148
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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