Provider Demographics
NPI:1194203208
Name:AMERI-LABS LLC
Entity Type:Organization
Organization Name:AMERI-LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DALLIN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-898-5536
Mailing Address - Street 1:541 W MAIN ST STE 160
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3666
Mailing Address - Country:US
Mailing Address - Phone:801-898-5536
Mailing Address - Fax:
Practice Address - Street 1:541 W MAIN ST STE 160
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3666
Practice Address - Country:US
Practice Address - Phone:312-265-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D2149383291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory