Provider Demographics
NPI:1346648870
Name:PRINCIPLE LABS LLC
Entity Type:Organization
Organization Name:PRINCIPLE LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:POLETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-353-6661
Mailing Address - Street 1:2550 BRODHEAD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8922
Mailing Address - Country:US
Mailing Address - Phone:484-353-6661
Mailing Address - Fax:484-353-6663
Practice Address - Street 1:2550 BRODHEAD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8922
Practice Address - Country:US
Practice Address - Phone:484-353-6661
Practice Address - Fax:484-353-6663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory