Provider Demographics
NPI:1770669376
Name:LABWORK LLC
Entity Type:Organization
Organization Name:LABWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-759-3817
Mailing Address - Street 1:PO BOX 1701
Mailing Address - Street 2:130 PENNSYLVANIA AVE
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1701
Mailing Address - Country:US
Mailing Address - Phone:301-722-7270
Mailing Address - Fax:301-722-7274
Practice Address - Street 1:130 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-4236
Practice Address - Country:US
Practice Address - Phone:301-722-7270
Practice Address - Fax:301-722-7274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD939291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD044RMedicare ID - Type Unspecified