Provider Demographics
NPI:1154850063
Name:MAXIMUM LAB SERVICES, LLC
Entity Type:Organization
Organization Name:MAXIMUM LAB SERVICES, LLC
Other - Org Name:MAXIMUM LAB SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RENARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-246-0600
Mailing Address - Street 1:2211 MARYLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5627
Mailing Address - Country:US
Mailing Address - Phone:410-246-0600
Mailing Address - Fax:866-815-6746
Practice Address - Street 1:2211 MARYLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5627
Practice Address - Country:US
Practice Address - Phone:410-246-0600
Practice Address - Fax:866-815-6746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory