Provider Demographics
NPI:1952876203
Name:APOLLO CLINICAL LABORATORIES INC.
Entity Type:Organization
Organization Name:APOLLO CLINICAL LABORATORIES INC.
Other - Org Name:QUALITY LABORATORY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/C.O.O.
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:
Authorized Official - Last Name:KURTYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-686-2300
Mailing Address - Street 1:2124 MORRIS AVE.
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6042
Mailing Address - Country:US
Mailing Address - Phone:908-686-2300
Mailing Address - Fax:908-686-2311
Practice Address - Street 1:2124 MORRIS AVE.
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6042
Practice Address - Country:US
Practice Address - Phone:908-686-2300
Practice Address - Fax:908-686-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory