Provider Demographics
NPI:1689170359
Name:HAI LAB DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:HAI LAB DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTRELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GABAY DE VARNAGY
Authorized Official - Suffix:
Authorized Official - Credentials:RPT,RMA,EKG,SA-C
Authorized Official - Phone:305-504-1240
Mailing Address - Street 1:15901 COLLINS AVE APT 804
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4764
Mailing Address - Country:US
Mailing Address - Phone:305-504-1240
Mailing Address - Fax:
Practice Address - Street 1:15901 COLLINS AVE APT 804
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4764
Practice Address - Country:US
Practice Address - Phone:305-504-1240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2017672021246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty