Provider Demographics
NPI:1821449653
Name:FLO LABS
Entity Type:Organization
Organization Name:FLO LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPROUL
Authorized Official - Suffix:
Authorized Official - Credentials:PBT
Authorized Official - Phone:747-245-5227
Mailing Address - Street 1:76141 DEERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-1684
Mailing Address - Country:US
Mailing Address - Phone:747-245-5227
Mailing Address - Fax:928-222-3678
Practice Address - Street 1:76141 DEERWOOD DR
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-1684
Practice Address - Country:US
Practice Address - Phone:747-245-5227
Practice Address - Fax:928-222-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory