MEDICARE: CLINICAL LAB PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1053298067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL LAB PARTNERS LLC

Provider Business Mailing Address
First Line	:	2761 VISTA PKWY STE E7
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-2737
Country	:	US
Telephone Number	:	888-769-9992
Fax Number	:	844-884-0932

Provider Business Practice Location Address
First Line	:	2761 VISTA PKWY STE E7
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-2737
Country	:	US
Telephone Number	:	888-769-9992
Fax Number	:	844-884-0932

Authorized Official
Title or Position	:	MANAGER
Name	:	GREGORY VAX
Credential	:
Telephone Number	:	888-769-9992

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

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