Provider Demographics
NPI:1740157148
Name:LABSTREAM LLC
Entity type:Organization
Organization Name:LABSTREAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LASHONDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-578-0521
Mailing Address - Street 1:116 FLORA WYCHE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-7610
Mailing Address - Country:US
Mailing Address - Phone:478-578-0521
Mailing Address - Fax:478-219-1524
Practice Address - Street 1:116 FLORA WYCHE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-7610
Practice Address - Country:US
Practice Address - Phone:478-578-0521
Practice Address - Fax:478-219-1524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory