Provider Demographics
NPI:1073941506
Name:U S LAB & RADIOLOGY LLC
Entity Type:Organization
Organization Name:U S LAB & RADIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-940-0389
Mailing Address - Street 1:2 JOHATHAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5549
Mailing Address - Country:US
Mailing Address - Phone:508-583-2000
Mailing Address - Fax:
Practice Address - Street 1:11 PENNS TRL STE 200
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4800
Practice Address - Country:US
Practice Address - Phone:800-786-8015
Practice Address - Fax:443-662-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory