Provider Demographics
NPI:1659787687
Name:ZION LABORATORY CORP.
Entity Type:Organization
Organization Name:ZION LABORATORY CORP.
Other - Org Name:DH LABORATORIES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-961-8801
Mailing Address - Street 1:1700 NW 65 AVE.
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313
Mailing Address - Country:US
Mailing Address - Phone:954-961-8801
Mailing Address - Fax:844-684-6670
Practice Address - Street 1:6555 NW 65 AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:954-299-1015
Practice Address - Fax:954-771-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-10
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2078436291U00000X
FL800027796291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory