Provider Demographics
NPI:1205642196
Name:MJ PRECISION TESTING CENTER & SERVICES
Entity type:Organization
Organization Name:MJ PRECISION TESTING CENTER & SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEPRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:239-249-4534
Mailing Address - Street 1:7812 BULLARA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-4918
Mailing Address - Country:US
Mailing Address - Phone:656-238-4203
Mailing Address - Fax:
Practice Address - Street 1:7402 N 56TH ST STE 100M
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-7746
Practice Address - Country:US
Practice Address - Phone:656-238-4203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory