Provider Demographics
NPI:1881289619
Name:LAB DISTRICT INC.
Entity type:Organization
Organization Name:LAB DISTRICT INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANIK
Authorized Official - Middle Name:
Authorized Official - Last Name:IZRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-826-3349
Mailing Address - Street 1:3911 HOLLYWOOD BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6795
Mailing Address - Country:US
Mailing Address - Phone:305-962-3072
Mailing Address - Fax:
Practice Address - Street 1:1000 PARK CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5373
Practice Address - Country:US
Practice Address - Phone:305-962-3072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory