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General NPI Number Information
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NPI Number | 1285957951
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Entity Type | Organization
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Legal Business Name | PB LABORATORIES LLC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 7451 S MILITARY TRL
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City | LAKE WORTH
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State | FL
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Zip | 33463-7800
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Country | US
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Telephone | 561-641-9024
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Fax | 561-641-9025
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Provider Business Mailing Address
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Address Line | 7451 S MILITARY TRL
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City | LAKE WORTH
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State | FL
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Zip | 33463-7800
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Country | US
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Telephone | 561-641-9024
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Fax | 561-641-9025
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Authorized Official
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Title or Position | COO
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Name | MS. SHARON HOLLIS
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Credential |
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Telephone | 561-855-1626
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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 | 800025714
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License Number State | FL
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