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General NPI Number Information
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NPI Number | 1184408817
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Entity Type | Organization
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Legal Business Name | OMEGA LABORATORIES INC
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 1500 NW 62ND ST STE 406
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1851
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Country | US
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Telephone | 917-702-1240
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 NW 62ND ST STE 406
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-1851
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Country | US
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Telephone | 917-702-1240
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ANTOINE R INGE
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Credential |
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Telephone | 917-702-1240
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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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