Provider Demographics
NPI:1821744905
Name:PHARMA GENLABS, LLC
Entity Type:Organization
Organization Name:PHARMA GENLABS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEROTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-953-1093
Mailing Address - Street 1:8170 SOUTH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6434
Mailing Address - Country:US
Mailing Address - Phone:330-953-1093
Mailing Address - Fax:
Practice Address - Street 1:8170 SOUTH AVE STE 3
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6434
Practice Address - Country:US
Practice Address - Phone:330-953-1093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-27
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory