Provider Demographics
NPI:1679813828
Name:OPKO LAB, LLC
Entity Type:Organization
Organization Name:OPKO LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-575-4138
Mailing Address - Street 1:1450 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-4531
Mailing Address - Country:US
Mailing Address - Phone:615-874-0410
Mailing Address - Fax:615-345-4653
Practice Address - Street 1:863 MITTEN RD
Practice Address - Street 2:SUITE C
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1307
Practice Address - Country:US
Practice Address - Phone:650-259-9565
Practice Address - Fax:615-345-4653
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPKO LAB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-26
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory