Provider Demographics
NPI:1942813050
Name:LAB DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:LAB DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:NETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-522-3999
Mailing Address - Street 1:1515 NW 167TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5148
Mailing Address - Country:US
Mailing Address - Phone:786-522-3999
Mailing Address - Fax:786-977-4394
Practice Address - Street 1:1515 NW 167TH ST STE 400
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-5148
Practice Address - Country:US
Practice Address - Phone:786-522-3999
Practice Address - Fax:786-977-4394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory