Provider Demographics
NPI:1922350545
Name:IG LABORATORY INC
Entity Type:Organization
Organization Name:IG LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHLHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-255-8880
Mailing Address - Street 1:2 INTERNATIONAL PLZ
Mailing Address - Street 2:SUITE 510
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2017
Mailing Address - Country:US
Mailing Address - Phone:615-255-8880
Mailing Address - Fax:615-255-1330
Practice Address - Street 1:2 INTERNATIONAL PLZ
Practice Address - Street 2:SUITE 510
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2017
Practice Address - Country:US
Practice Address - Phone:615-255-8880
Practice Address - Fax:615-255-1330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSIGHT GENETICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44D2041004291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory