Provider Demographics
NPI:1316523327
Name:VIP LAB SOLUTIONS
Entity type:Organization
Organization Name:VIP LAB SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANEIKA
Authorized Official - Middle Name:LARISA
Authorized Official - Last Name:SADDLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-490-5913
Mailing Address - Street 1:232 CALDWELL LOOP
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-8397
Mailing Address - Country:US
Mailing Address - Phone:347-490-5913
Mailing Address - Fax:888-270-4341
Practice Address - Street 1:232 CALDWELL LOOP
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-8397
Practice Address - Country:US
Practice Address - Phone:347-490-5913
Practice Address - Fax:888-270-4341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-20
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory