Provider Demographics
NPI:1003066754
Name:LABS, INC.
Entity Type:Organization
Organization Name:LABS, INC.
Other - Org Name:LABS-NORTHEAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HEARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-528-4770
Mailing Address - Street 1:6933-B SOUTH REVERE PKWY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:720-528-4770
Mailing Address - Fax:
Practice Address - Street 1:401 N 3RD ST
Practice Address - Street 2:SUITE 279
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-4101
Practice Address - Country:US
Practice Address - Phone:720-488-4480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA39D1088340291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06HL05Medicare Oscar/Certification