Provider Demographics
NPI:1710127279
Name:NEOGENOMICS LABORATORIES INC
Entity Type:Organization
Organization Name:NEOGENOMICS LABORATORIES INC
Other - Org Name:NEOGENOMICS LABORATORIES INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:GASPARINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-776-5907
Mailing Address - Street 1:PO BOX 864110
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-4110
Mailing Address - Country:US
Mailing Address - Phone:866-776-5907
Mailing Address - Fax:239-690-4236
Practice Address - Street 1:9548 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4011
Practice Address - Country:US
Practice Address - Phone:866-776-5907
Practice Address - Fax:818-700-1871
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEOGENOMICS LABORATORIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-24
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF337277291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory