Provider Demographics
NPI:1548772205
Name:UNITED LABORATORY SERVICES OF AMERICA
Entity Type:Organization
Organization Name:UNITED LABORATORY SERVICES OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBOLUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:CMA/CHI
Authorized Official - Phone:609-214-5118
Mailing Address - Street 1:148 CIMINO BLVD
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-9311
Mailing Address - Country:US
Mailing Address - Phone:609-214-5118
Mailing Address - Fax:609-343-1431
Practice Address - Street 1:1325 BALTIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-4516
Practice Address - Country:US
Practice Address - Phone:609-214-5118
Practice Address - Fax:609-343-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory