Provider Demographics
NPI:1225650070
Name:LAB X HEALTH II
Entity Type:Organization
Organization Name:LAB X HEALTH II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STRYJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-322-3858
Mailing Address - Street 1:C/O OF LAB X HEALTH
Mailing Address - Street 2:4 BRIGHTON RD STE 308
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1665
Mailing Address - Country:US
Mailing Address - Phone:973-591-3623
Mailing Address - Fax:973-591-1410
Practice Address - Street 1:4 BRIGHTON RD STE 308
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1665
Practice Address - Country:US
Practice Address - Phone:973-591-3623
Practice Address - Fax:973-591-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory