Provider Demographics
NPI:1245510742
Name:LABS 2 GO
Entity type:Organization
Organization Name:LABS 2 GO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RODGER
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C, RN
Authorized Official - Phone:817-901-7855
Mailing Address - Street 1:2909 YOAKUM ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-8906
Mailing Address - Country:US
Mailing Address - Phone:817-901-7855
Mailing Address - Fax:
Practice Address - Street 1:2909 YOAKUM ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-8906
Practice Address - Country:US
Practice Address - Phone:817-901-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07124291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory