Provider Demographics
NPI:1912363839
Name:SPOT ON LABS LLC
Entity Type:Organization
Organization Name:SPOT ON LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-635-3025
Mailing Address - Street 1:PO BOX 1462
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-1462
Mailing Address - Country:US
Mailing Address - Phone:561-635-3025
Mailing Address - Fax:
Practice Address - Street 1:3706 CRONDALL LN STE 101D
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2234
Practice Address - Country:US
Practice Address - Phone:561-635-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory