Provider Demographics
NPI:1407632201
Name:LIVINGWELL LABS INC.
Entity Type:Organization
Organization Name:LIVINGWELL LABS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHINEDU
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:817-266-8583
Mailing Address - Street 1:5224 S STATE HIGHWAY 360 STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0934
Mailing Address - Country:US
Mailing Address - Phone:214-235-0371
Mailing Address - Fax:
Practice Address - Street 1:5224 S STATE HIGHWAY 360 STE 225
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0934
Practice Address - Country:US
Practice Address - Phone:214-235-0371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory