Provider Demographics
NPI:1932783883
Name:VEINIFAST MOBILE LABORATORY SERVICES
Entity Type:Organization
Organization Name:VEINIFAST MOBILE LABORATORY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:SHIRLVETTE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:757-943-4772
Mailing Address - Street 1:2205 HILTON CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-3913
Mailing Address - Country:US
Mailing Address - Phone:757-943-4772
Mailing Address - Fax:
Practice Address - Street 1:2205 HILTON CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3913
Practice Address - Country:US
Practice Address - Phone:757-943-4772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory