Provider Demographics
NPI:1083061261
Name:SCION LAB SERVICES, LLC
Entity Type:Organization
Organization Name:SCION LAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-373-8899
Mailing Address - Street 1:4111 SW 47TH AVE STE 335
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4039
Mailing Address - Country:US
Mailing Address - Phone:954-715-5040
Mailing Address - Fax:
Practice Address - Street 1:4111 SW 47TH AVE STE 335
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4039
Practice Address - Country:US
Practice Address - Phone:954-369-1083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory