ESSENTIAL LAB NPI 1063178127

NPI Information

ESSENTIAL LAB is a clinic center in Fort Wayne, IN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ESSENTIAL LAB NPI is 1063178127. The provider is registered as an organization entity type.

The provider's business location address is:

6324 CONSTITUTION DR
FORT WAYNE, IN
ZIP 46804-518
Phone: (260) 467-9837

The provider's authorized official is Sedricka Epperson .
The authorized official title is Ceo and has the following contact phone number (260) 467-9837.

The CLIA number assigned to this NPI record is 15D2240358 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/12/2021 and was last updated on 11/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.