Healthcare Provider Details

I. General information

NPI: 1366513038
Provider Name (Legal Business Name): FIRST QUALITY LABORATORY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20861 JOHNSON ST STE 117
PEMBROKE PINES FL
33029-1927
US

IV. Provider business mailing address

20861 JOHNSON ST STE 117
PEMBROKE PINES FL
33029-1927
US

V. Phone/Fax

Practice location:
  • Phone: 954-430-4424
  • Fax: 954-430-4412
Mailing address:
  • Phone: 954-430-4424
  • Fax: 954-430-4412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number800021760
License Number StateFL

VIII. Authorized Official

Name: MRS. MARIA M GARCIA
Title or Position: PRESIDENT
Credential: PRESIDENT
Phone: 954-430-4424