Provider Demographics
NPI:1679167555
Name:LAB TESS
Entity Type:Organization
Organization Name:LAB TESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-254-8521
Mailing Address - Street 1:8601 PLACIDA ROAD
Mailing Address - Street 2:#834
Mailing Address - City:PLACIDA
Mailing Address - State:FL
Mailing Address - Zip Code:33946
Mailing Address - Country:US
Mailing Address - Phone:404-254-8521
Mailing Address - Fax:
Practice Address - Street 1:5771 JOHNSON ST # 3869
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5633
Practice Address - Country:US
Practice Address - Phone:754-230-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty