Provider Demographics
NPI:1174833164
Name:MEDLABS
Entity Type:Organization
Organization Name:MEDLABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:AKERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-499-2672
Mailing Address - Street 1:PO BOX 2135
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85244-2135
Mailing Address - Country:US
Mailing Address - Phone:602-499-2672
Mailing Address - Fax:
Practice Address - Street 1:2050 E UNIVERSITY DR STE 5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6700
Practice Address - Country:US
Practice Address - Phone:602-499-2672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory