Provider Demographics
NPI:1386325066
Name:LABS ON THE GO
Entity type:Organization
Organization Name:LABS ON THE GO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-287-3703
Mailing Address - Street 1:2320 TREE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2729
Mailing Address - Country:US
Mailing Address - Phone:321-287-3703
Mailing Address - Fax:407-681-4603
Practice Address - Street 1:2822 FORSYTH RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-6684
Practice Address - Country:US
Practice Address - Phone:321-287-3703
Practice Address - Fax:407-681-4603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory