Provider Demographics
NPI:1932572484
Name:METRO DX LABS CORPORATION
Entity Type:Organization
Organization Name:METRO DX LABS CORPORATION
Other - Org Name:METRO DX LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-810-4141
Mailing Address - Street 1:710 US HIGHWAY 46
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1540
Mailing Address - Country:US
Mailing Address - Phone:973-810-4141
Mailing Address - Fax:973-810-4334
Practice Address - Street 1:710 US HIGHWAY 46
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1540
Practice Address - Country:US
Practice Address - Phone:973-810-4141
Practice Address - Fax:973-810-4334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ00037417291U00000X
NJ0009631291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory