Provider Demographics
NPI:1699970905
Name:TOTAL TEST LAB LLC
Entity type:Organization
Organization Name:TOTAL TEST LAB LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEICHELBECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-215-9417
Mailing Address - Street 1:7798 READING RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-2141
Mailing Address - Country:US
Mailing Address - Phone:513-761-3375
Mailing Address - Fax:513-761-4505
Practice Address - Street 1:7798 READING RD
Practice Address - Street 2:SUITE 4
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-2141
Practice Address - Country:US
Practice Address - Phone:513-761-3375
Practice Address - Fax:513-761-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory