Provider Demographics
NPI:1265278634
Name:KI LABS DIAGNOSTICS
Entity type:Organization
Organization Name:KI LABS DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOLIKKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESSART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-910-6318
Mailing Address - Street 1:5598 8TH ST W UNIT 1
Mailing Address - Street 2:OFFICE 7
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-6341
Mailing Address - Country:US
Mailing Address - Phone:239-910-6318
Mailing Address - Fax:
Practice Address - Street 1:5598 8TH ST W UNIT 1
Practice Address - Street 2:OFFICE 7
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-6341
Practice Address - Country:US
Practice Address - Phone:239-910-6318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty