Provider Demographics
NPI:1558015933
Name:ONE CALL AWAY LABS SERVICES
Entity Type:Organization
Organization Name:ONE CALL AWAY LABS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-974-6632
Mailing Address - Street 1:13720 OLD SAINT AUGUSTINE RD STE 8-236
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-7414
Mailing Address - Country:US
Mailing Address - Phone:866-974-6632
Mailing Address - Fax:866-974-6632
Practice Address - Street 1:13720 OLD SAINT AUGUSTINE RD STE 8-236
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-7414
Practice Address - Country:US
Practice Address - Phone:866-974-6632
Practice Address - Fax:866-974-6632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory