MEDICARE: R&B LABS 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	:	1245084722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R&B LABS LLC

Provider Business Mailing Address
First Line	:	2276 FLATBUSH AVE # 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4518
Country	:	US
Telephone Number	:	917-859-4704
Fax Number	:	718-734-2499

Provider Business Practice Location Address
First Line	:	2276 FLATBUSH AVE # 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4518
Country	:	US
Telephone Number	:	917-859-4704
Fax Number	:	718-734-2499

Authorized Official
Title or Position	:	OWNER
Name	:	JENNA LOPEZ
Credential	:
Telephone Number	:	917-859-4704

Provider Enumeration Date	:	04/12/2024
Last Update Date	:	04/13/2024

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