Provider Demographics
NPI:1467805432
Name:BIO REFERENCE LABORATORIES, INC.
Entity Type:Organization
Organization Name:BIO REFERENCE LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO; EXECUTIVE VP
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ERDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-229-5227
Mailing Address - Street 1:481 EDWARD H ROSS DR
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-3118
Mailing Address - Country:US
Mailing Address - Phone:800-229-5227
Mailing Address - Fax:201-791-0139
Practice Address - Street 1:27 HOSPITAL AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5954
Practice Address - Country:US
Practice Address - Phone:800-229-5227
Practice Address - Fax:201-791-0139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPKO HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-14
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT07D2063361291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008035335Medicaid
NJ301910Medicare PIN