Provider Demographics
NPI:1972142784
Name:DX LABORATORIES LLC
Entity Type:Organization
Organization Name:DX LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:GINSBERG-BIEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-930-1315
Mailing Address - Street 1:823 SE OSCEOLA ST STE 7
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2431
Mailing Address - Country:US
Mailing Address - Phone:855-930-1315
Mailing Address - Fax:
Practice Address - Street 1:823 SE OSCEOLA ST STE 7
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2431
Practice Address - Country:US
Practice Address - Phone:855-930-1315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D2175863OtherCLIA
FL29875OtherCOLA