Provider Demographics
NPI:1235515008
Name:TOXICOLOGY LAB SOLUTIONS
Entity Type:Organization
Organization Name:TOXICOLOGY LAB SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALENO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:786-457-7014
Mailing Address - Street 1:16855 NE 2ND AVE
Mailing Address - Street 2:SUITE 101N
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1744
Mailing Address - Country:US
Mailing Address - Phone:305-944-1516
Mailing Address - Fax:888-510-9071
Practice Address - Street 1:16855 NE 2ND AVE
Practice Address - Street 2:SUITE 101N
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1744
Practice Address - Country:US
Practice Address - Phone:305-944-1516
Practice Address - Fax:888-510-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherTOXICOLOGY LAB