Provider Demographics
NPI:1003238676
Name:PRO-LAB, LLC
Entity Type:Organization
Organization Name:PRO-LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:864-672-3925
Mailing Address - Street 1:545 N PLEASANTBURG DR
Mailing Address - Street 2:SUITE 121B
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2183
Mailing Address - Country:US
Mailing Address - Phone:864-672-3925
Mailing Address - Fax:864-672-3924
Practice Address - Street 1:545 N PLEASANTBURG DR
Practice Address - Street 2:SUITE 121B
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2183
Practice Address - Country:US
Practice Address - Phone:864-672-3925
Practice Address - Fax:864-672-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory