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General NPI Number Information
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NPI Number | 1265029300
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Entity Type | Organization
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Legal Business Name | LAB 24 LLC
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 11660 ALPHARETTA HWY STE 740
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City | ROSWELL
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State | GA
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Zip | 30076-4916
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Country | US
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Telephone | 800-641-0133
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Fax | 800-833-1066
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Provider Business Mailing Address
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Address Line | 2840 NW 2ND AVE STE 201
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City | BOCA RATON
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State | FL
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Zip | 33431-6692
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Country | US
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Telephone | 800-641-0133
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Fax | 800-833-1066
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS ALBERINO SR.
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Credential |
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Telephone | 800-641-0133
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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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