Provider Demographics
NPI:1053721373
Name:TAUSTIN LABORATORIES
Entity type:Organization
Organization Name:TAUSTIN LABORATORIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-868-3167
Mailing Address - Street 1:2868 ACTON RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2502
Mailing Address - Country:US
Mailing Address - Phone:855-319-4459
Mailing Address - Fax:877-796-6185
Practice Address - Street 1:2868 ACTON RD
Practice Address - Street 2:SUITE 207
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2502
Practice Address - Country:US
Practice Address - Phone:855-319-4459
Practice Address - Fax:877-796-6185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory