Provider Demographics
NPI:1821684515
Name:BIOGEN LABS
Entity Type:Organization
Organization Name:BIOGEN LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASRA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-501-3866
Mailing Address - Street 1:4007 GREENBRIAR DR STE E
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3923
Mailing Address - Country:US
Mailing Address - Phone:478-501-3866
Mailing Address - Fax:
Practice Address - Street 1:4007 GREENBRIAR DR STE E
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3923
Practice Address - Country:US
Practice Address - Phone:478-501-3866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory