Provider Demographics
NPI:1508187147
Name:AFFORDABLE LAB LLC
Entity Type:Organization
Organization Name:AFFORDABLE LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPPEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-435-8050
Mailing Address - Street 1:2530 CROOKS RD STE 2
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-3300
Mailing Address - Country:US
Mailing Address - Phone:248-435-8050
Mailing Address - Fax:
Practice Address - Street 1:2530 CROOKS RD STE 2
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-3300
Practice Address - Country:US
Practice Address - Phone:248-435-8050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23D2007223291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory