Provider Demographics
NPI:1457120115
Name:GIFTED HANDS LABORATORY LLC
Entity Type:Organization
Organization Name:GIFTED HANDS LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CCMA
Authorized Official - Phone:317-361-6988
Mailing Address - Street 1:2040 N LUETT AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-2407
Mailing Address - Country:US
Mailing Address - Phone:317-361-6988
Mailing Address - Fax:888-714-7802
Practice Address - Street 1:5699 E 71ST ST STE 2A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3950
Practice Address - Country:US
Practice Address - Phone:317-444-1487
Practice Address - Fax:888-714-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory