Healthcare Provider Details

I. General information

NPI: 1033520028
Provider Name (Legal Business Name): PERKINELMER LABS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 RULAND RD SUITE #1
MELVILLE NY
11747-4211
US

IV. Provider business mailing address

80 RULAND RD SUITE #1
MELVILLE NY
11747-4211
US

V. Phone/Fax

Practice location:
  • Phone: 631-425-0800
  • Fax: 631-425-0811
Mailing address:
  • Phone: 631-425-0800
  • Fax: 631-425-0811

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: MS. MANISHA RECK
Title or Position: SITE LEADER/PKI LAB
Credential:
Phone: 631-425-0800