Provider Demographics
NPI:1033085816
Name:LUNAR LABORATORIES LLC
Entity type:Organization
Organization Name:LUNAR LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MBAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-988-6436
Mailing Address - Street 1:7805 SW ELLIPSE WAY STE A19
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7263
Mailing Address - Country:US
Mailing Address - Phone:561-288-8550
Mailing Address - Fax:
Practice Address - Street 1:7805 SW ELLIPSE WAY STE A19
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-7263
Practice Address - Country:US
Practice Address - Phone:561-288-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory