Provider Demographics
NPI:1871860189
Name:COMPASS LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:COMPASS LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:HABDORF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-348-5771
Mailing Address - Street 1:250 GOVERNORS DR SE
Mailing Address - Street 2:SUITE H
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-2728
Mailing Address - Country:US
Mailing Address - Phone:901-348-5771
Mailing Address - Fax:
Practice Address - Street 1:250 GOVERNORS DR SE
Practice Address - Street 2:SUITE H
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-2728
Practice Address - Country:US
Practice Address - Phone:901-348-5771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory