Provider Demographics
NPI:1740721455
Name:RELIABLE LAB GROUP,LLC.
Entity type:Organization
Organization Name:RELIABLE LAB GROUP,LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-248-7128
Mailing Address - Street 1:900 OSCEOLA DR STE 223
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-5075
Mailing Address - Country:US
Mailing Address - Phone:561-200-8723
Mailing Address - Fax:
Practice Address - Street 1:500 COMMERCE WAY W
Practice Address - Street 2:UNIT 5
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8844
Practice Address - Country:US
Practice Address - Phone:561-200-8723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory