Provider Demographics
NPI:1659988095
Name:LABQ CLINICAL DIAGNOSTICS LLC DBA LABQ DIAGNOSTICS
Entity Type:Organization
Organization Name:LABQ CLINICAL DIAGNOSTICS LLC DBA LABQ DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-534-5227
Mailing Address - Street 1:140 58TH ST
Mailing Address - Street 2:BLDG A STE 3L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2539
Mailing Address - Country:US
Mailing Address - Phone:718-534-5227
Mailing Address - Fax:718-534-5229
Practice Address - Street 1:4510 16TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1101
Practice Address - Country:US
Practice Address - Phone:718-247-8000
Practice Address - Fax:718-247-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory