Provider Demographics
NPI:1811655970
Name:UTOPIAN LAB SOLUTIONS LLC.
Entity type:Organization
Organization Name:UTOPIAN LAB SOLUTIONS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:904-322-4351
Mailing Address - Street 1:5959 FORT CAROLINE RD APT 1702
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-1842
Mailing Address - Country:US
Mailing Address - Phone:904-322-4351
Mailing Address - Fax:866-321-0366
Practice Address - Street 1:4016 SOUTH THIRD STREET #1016
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3225
Practice Address - Country:US
Practice Address - Phone:904-322-4351
Practice Address - Fax:866-321-0366
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTOPIAN SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-06
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory