Healthcare Provider Details

I. General information

NPI: 1902767775
Provider Name (Legal Business Name): SPECIALTY LABS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8481 SERENA CREEK AVE
BOYNTON BEACH FL
33473-4957
US

IV. Provider business mailing address

PO BOX 741621
BOYNTON BEACH FL
33474-1621
US

V. Phone/Fax

Practice location:
  • Phone: 561-203-5657
  • Fax: 561-898-1523
Mailing address:
  • Phone: 561-203-5657
  • Fax: 561-898-1523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DANIEL LEGER
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 561-203-5657