Provider Demographics
NPI:1972274561
Name:SUREPOINT DIAGNOSTIXXS LLC
Entity Type:Organization
Organization Name:SUREPOINT DIAGNOSTIXXS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:UELI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-681-9446
Mailing Address - Street 1:608 JOHNSON AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-2690
Mailing Address - Country:US
Mailing Address - Phone:631-737-4168
Mailing Address - Fax:
Practice Address - Street 1:608 JOHNSON AVE STE 7
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2690
Practice Address - Country:US
Practice Address - Phone:631-737-4168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory