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General NPI Number Information
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NPI Number | 1265094452
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Entity Type | Organization
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Legal Business Name | GALAXY LABS LLC
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/09/2019
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Provider Practice Location Address
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Address Line | 9980 CENTRAL PARK BLVD N
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City | BOCA RATON
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State | FL
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Zip | 33428-1762
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Country | US
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Telephone | 855-968-7522
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Fax | 561-828-2818
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Provider Business Mailing Address
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Address Line | 9980 CENTRAL PARK BLVD N STE 116
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City | BOCA RATON
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State | FL
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Zip | 33428-1703
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Country | US
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Telephone | 860-574-2710
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Fax | 561-828-2818
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Authorized Official
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Title or Position | OWNER
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Name | EVAN KAISER
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Credential |
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Telephone | 855-968-7522
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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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