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General NPI Number Information
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NPI Number | 1104586767
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Entity Type | Organization
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Legal Business Name | COVID TESTING LABS LLC
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 3737 PECOS MCLEOD INTERCONNECT
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City | LAS VEGAS
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State | NV
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Zip | 89121-4262
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Country | US
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Telephone | 725-240-0608
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Fax | 888-356-3518
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Provider Business Mailing Address
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Address Line | 3737 PECOS MCLEOD INTERCONNECT
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City | LAS VEGAS
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State | NV
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Zip | 89121-4262
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Country | US
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Telephone | 725-240-0608
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Fax | 888-356-3518
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Authorized Official
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Title or Position | CEO
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Name | DR. EDMOND SARRAF
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Credential | MD
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Telephone | 725-240-0608
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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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