Provider Demographics
NPI:1891456695
Name:FAST LAB CORP
Entity Type:Organization
Organization Name:FAST LAB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:MUNTIQA
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-997-8787
Mailing Address - Street 1:285 SILLS RD
Mailing Address - Street 2:BLDG 8 STE D
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:856-221-8225
Mailing Address - Fax:631-204-6300
Practice Address - Street 1:285 SILLS RD
Practice Address - Street 2:BLDG 8 STE D
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:856-221-8225
Practice Address - Fax:631-204-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory