Provider Demographics
NPI:1013785963
Name:MICRON LABS ON DEMAND
Entity Type:Organization
Organization Name:MICRON LABS ON DEMAND
Other - Org Name:MICRON LABS ON DEMAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARINATWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-599-4223
Mailing Address - Street 1:8151 BAYBERRY CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4613
Mailing Address - Country:US
Mailing Address - Phone:571-599-4223
Mailing Address - Fax:
Practice Address - Street 1:8151 BAYBERRY CT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4613
Practice Address - Country:US
Practice Address - Phone:157-159-9422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty