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General NPI Number Information
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NPI Number | 1144975483
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Entity Type | Organization
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Legal Business Name | EMPIRE LABS LLC
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 532 MADISON ST
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City | BROOKLYN
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State | NY
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Zip | 11221-6544
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Country | US
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Telephone | 984-220-7446
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Fax |
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Provider Business Mailing Address
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Address Line | 110 MINGOCREST DR
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City | KNIGHTDALE
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State | NC
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Zip | 27545-7667
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Country | US
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Telephone | 984-220-7446
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Fax |
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Authorized Official
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Title or Position | MANAGER OWNETR
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Name | PATRIC LEE MITCHELL
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Credential |
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Telephone | 984-220-7446
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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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