Provider Demographics
NPI:1972369213
Name:LAB ON THE RUN LLC
Entity Type:Organization
Organization Name:LAB ON THE RUN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIRAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:757-737-5163
Mailing Address - Street 1:900 COMMONWEALTH PL STE 200
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4530
Mailing Address - Country:US
Mailing Address - Phone:757-737-5163
Mailing Address - Fax:
Practice Address - Street 1:900 COMMONWEALTH PL STE 200
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4530
Practice Address - Country:US
Practice Address - Phone:757-737-5163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory