MEDICARE: ACULABS INC

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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
2	291U00000X	Clinical Medical Laboratory	00006219	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093749087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACULABS INC

Provider Business Mailing Address
First Line	:	2 KENNEDY BLVD
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1248
Country	:	US
Telephone Number	:	732-777-2588
Fax Number	:	732-777-2601

Provider Business Practice Location Address
First Line	:	2 KENNEDY BLVD
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1248
Country	:	US
Telephone Number	:	732-777-2588
Fax Number	:	732-777-2601

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PETER GUDAITIS
Credential	:
Telephone Number	:	732-777-2588

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	12/04/2012

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