Provider Demographics
NPI:1629653514
Name:UNLIMITED LAB LLC
Entity Type:Organization
Organization Name:UNLIMITED LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMY TECH
Authorized Official - Prefix:
Authorized Official - First Name:BIELKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWIATKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PBT
Authorized Official - Phone:732-351-0024
Mailing Address - Street 1:14 CAPITOL REEF RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-9005
Mailing Address - Country:US
Mailing Address - Phone:732-351-0024
Mailing Address - Fax:
Practice Address - Street 1:14 CAPITOL REEF RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-9005
Practice Address - Country:US
Practice Address - Phone:732-351-0024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7323510024Other7323510024