Provider Demographics
NPI:1437771052
Name:PHLEBOTOMY INK ALLIED HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:PHLEBOTOMY INK ALLIED HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAKIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-582-9075
Mailing Address - Street 1:1100 E PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2563
Mailing Address - Country:US
Mailing Address - Phone:205-582-9075
Mailing Address - Fax:205-582-9079
Practice Address - Street 1:1100 E PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-2563
Practice Address - Country:US
Practice Address - Phone:205-582-9075
Practice Address - Fax:205-582-9079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service