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Organization

LAB TEST CLUB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BEN DAVID MD (CHIEF MEDICAL DIRECTOR)
(858) 255-4242
Entity
Organization

Contact information

Practice address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(858) 255-4242
Mailing address
1309 COFFEEN AVE STE 1200, SHERIDAN, WY 82801-5777
(858) 255-4242

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
01/04/2023
Last updated
10/26/2023
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