Provider Demographics
NPI:1669867495
Name:THE LABORATORY COMPANY
Entity type:Organization
Organization Name:THE LABORATORY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MELARAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-536-0254
Mailing Address - Street 1:2340 SW POMA DR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990
Mailing Address - Country:US
Mailing Address - Phone:561-762-5314
Mailing Address - Fax:772-382-2482
Practice Address - Street 1:2340 SW POMA DR
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990
Practice Address - Country:US
Practice Address - Phone:561-762-5314
Practice Address - Fax:772-382-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory