Provider Demographics
NPI:1083325641
Name:ATOWN LABS, LLC
Entity Type:Organization
Organization Name:ATOWN LABS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPB, CPB
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:FANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-995-3704
Mailing Address - Street 1:9471 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-5513
Mailing Address - Country:US
Mailing Address - Phone:760-579-8430
Mailing Address - Fax:
Practice Address - Street 1:9471 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-5513
Practice Address - Country:US
Practice Address - Phone:760-579-8430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty