Provider Demographics
NPI:1477811503
Name:PHYSICIANS LAB, INC.
Entity Type:Organization
Organization Name:PHYSICIANS LAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRISCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-972-9553
Mailing Address - Street 1:4850 T REX AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4443
Mailing Address - Country:US
Mailing Address - Phone:800-525-4052
Mailing Address - Fax:877-661-6178
Practice Address - Street 1:4850 T REX AVE STE 150
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4443
Practice Address - Country:US
Practice Address - Phone:877-316-8686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2036071291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory