Healthcare Provider Details

I. General information

NPI: 1316801293
Provider Name (Legal Business Name): DMLT LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 CHARTIERS AVE
MC KEES ROCKS PA
15136-3846
US

IV. Provider business mailing address

607 CHARTIERS AVE
MC KEES ROCKS PA
15136-3846
US

V. Phone/Fax

Practice location:
  • Phone: 859-310-0787
  • Fax:
Mailing address:
  • Phone: 859-310-0787
  • Fax:

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: MR. MANOJKUMAR N DESAI
Title or Position: OWNER
Credential: DIRECTOR
Phone: 859-310-0787