Provider Demographics
NPI:1275367112
Name:DEVANSH LAB WERKS,INC
Entity type:Organization
Organization Name:DEVANSH LAB WERKS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUDHAKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHARLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-994-8266
Mailing Address - Street 1:6600 PAIGE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-1841
Mailing Address - Country:US
Mailing Address - Phone:205-994-8266
Mailing Address - Fax:205-201-4797
Practice Address - Street 1:10912 COLONEL GLENN RD STE 1000
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8257
Practice Address - Country:US
Practice Address - Phone:205-994-8266
Practice Address - Fax:205-201-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR04D2307358OtherCLIA