Provider Demographics
NPI:1912617259
Name:LAB EXPRESS USA CORP
Entity Type:Organization
Organization Name:LAB EXPRESS USA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-554-6457
Mailing Address - Street 1:8400 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6244
Mailing Address - Country:US
Mailing Address - Phone:646-554-6457
Mailing Address - Fax:
Practice Address - Street 1:8400 RIVER RD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6244
Practice Address - Country:US
Practice Address - Phone:646-554-6457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory