Provider Demographics
NPI:1992865661
Name:PAR LABORATORY
Entity Type:Organization
Organization Name:PAR LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-545-7564
Mailing Address - Street 1:6150 150TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2138
Mailing Address - Country:US
Mailing Address - Phone:727-538-7227
Mailing Address - Fax:727-507-6204
Practice Address - Street 1:6150 150TH AVE N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-2138
Practice Address - Country:US
Practice Address - Phone:727-538-7227
Practice Address - Fax:727-507-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE9162Medicare ID - Type UnspecifiedMCR