Provider Demographics
NPI:1063083202
Name:HALO LABS LLC
Entity type:Organization
Organization Name:HALO LABS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-327-5560
Mailing Address - Street 1:8101 KUYKENDAHL RD UNIT 500
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1563
Mailing Address - Country:US
Mailing Address - Phone:346-327-5560
Mailing Address - Fax:866-252-3902
Practice Address - Street 1:8101 KUYKENDAHL RD UNIT 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77382-1563
Practice Address - Country:US
Practice Address - Phone:346-327-5560
Practice Address - Fax:866-252-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory