Healthcare Provider Details

I. General information

NPI: 1114312691
Provider Name (Legal Business Name): HLS LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 04/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 NE 3RD ST
DEERFIELD BEACH FL
33441-3705
US

IV. Provider business mailing address

1976 NE 3RD ST
DEERFIELD BEACH FL
33441-3705
US

V. Phone/Fax

Practice location:
  • Phone: 813-644-7753
  • Fax: 888-482-2405
Mailing address:
  • Phone: 813-644-7753
  • Fax: 888-482-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMY SMITH
Title or Position: TITLE MANAGER
Credential:
Phone: 813-644-7753