Provider Demographics
NPI:1336300060
Name:OH-LABS LLC
Entity Type:Organization
Organization Name:OH-LABS LLC
Other - Org Name:OPTIMAL HEALTH LABORATORIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:F
Authorized Official - Last Name:CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-275-4884
Mailing Address - Street 1:PO BOX 191089
Mailing Address - Street 2:123
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-8089
Mailing Address - Country:US
Mailing Address - Phone:214-717-4683
Mailing Address - Fax:
Practice Address - Street 1:3521 OAK LAWN AVE
Practice Address - Street 2:123
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4309
Practice Address - Country:US
Practice Address - Phone:214-717-4683
Practice Address - Fax:484-970-6356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51360207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty