Provider Demographics
NPI:1164924254
Name:MED SCREEN LABORATORIES INC
Entity Type:Organization
Organization Name:MED SCREEN LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISHRAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ILYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-587-2211
Mailing Address - Street 1:992 CLIFTON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:992 CLIFTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3502
Practice Address - Country:US
Practice Address - Phone:551-587-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory