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General NPI Number Information
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NPI Number | 1023362654
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Entity Type | Organization
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Legal Business Name | QM LABS, INC.
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 115 HICKORY ST SUITE 104
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City | MELBOURNE
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State | FL
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Zip | 32904-3505
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Country | US
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Telephone | 210-382-9698
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Fax | 888-330-4436
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Provider Business Mailing Address
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Address Line | 115 HICKORY ST SUITE 104
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City | MELBOURNE
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State | FL
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Zip | 32904-3505
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Country | US
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Telephone | 210-382-9698
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Fax | 888-330-4436
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MARY A. LAWRENCE
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Credential |
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Telephone | 210-382-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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