Provider Demographics
NPI:1326677725
Name:TELOSTRAND LAB LLC
Entity Type:Organization
Organization Name:TELOSTRAND LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO TRUSTEE/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-294-1514
Mailing Address - Street 1:680 KINDERKAMACK RD STE 101C
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1600
Mailing Address - Country:US
Mailing Address - Phone:201-994-4069
Mailing Address - Fax:201-301-8892
Practice Address - Street 1:680 KINDERKAMACK RD STE 101C
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1600
Practice Address - Country:US
Practice Address - Phone:201-994-4069
Practice Address - Fax:201-301-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory