Provider Demographics
NPI:1326491184
Name:MEGA PROTECT SERVICES LLC
Entity Type:Organization
Organization Name:MEGA PROTECT SERVICES LLC
Other - Org Name:MEGA LAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLATUNJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-278-4271
Mailing Address - Street 1:1950 OPITZ BLVD
Mailing Address - Street 2:STREET ADDRESS 2
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-2371
Mailing Address - Country:US
Mailing Address - Phone:571-408-4004
Mailing Address - Fax:703-986-3139
Practice Address - Street 1:1950 OPITZ BLVD # 2
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3304
Practice Address - Country:US
Practice Address - Phone:571-408-4004
Practice Address - Fax:703-986-3139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAS4092401291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory