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General NPI Number Information
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NPI Number | 1215747761
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Entity Type | Organization
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Legal Business Name | SAND POINT LABORATORIES, LLC
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 3435 S HOPKINS AVE STE 4
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City | TITUSVILLE
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State | FL
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Zip | 32780-5681
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Country | US
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Telephone | 305-213-3856
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Fax |
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Provider Business Mailing Address
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Address Line | 3435 S HOPKINS AVE STE 4
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City | TITUSVILLE
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State | FL
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Zip | 32780-5681
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Country | US
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Telephone | 305-213-3856
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GOCHA KHVICHIA
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Credential |
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Telephone | 305-213-3856
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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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