Provider Demographics
NPI:1447619473
Name:ACT BIOSYSTEMS LLC
Entity Type:Organization
Organization Name:ACT BIOSYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-929-9928
Mailing Address - Street 1:1325 S KILLIAN DR
Mailing Address - Street 2:UNIT 2A
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1965
Mailing Address - Country:US
Mailing Address - Phone:561-929-9928
Mailing Address - Fax:
Practice Address - Street 1:1325 S KILLIAN DR
Practice Address - Street 2:UNIT 2A
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-1965
Practice Address - Country:US
Practice Address - Phone:561-929-9928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory