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General NPI Number Information
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NPI Number | 1356454755
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Entity Type | Organization
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Legal Business Name | CMLAB INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 20861 JOHNSON STREET SUITE 117-118
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City | PEMBROKE PINES
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State | FL
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Zip | 33029
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Country | US
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Telephone | 954-704-9116
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Fax | 954-704-8823
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Provider Business Mailing Address
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Address Line | 20861 JOHNSON ST SUITE 117-118
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1926
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Country | US
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Telephone | 954-704-9116
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Fax | 954-704-8823
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Authorized Official
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Title or Position | MEDICAL TECHNOLOGIST SUPERVISOR VP
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Name | MRS. MARTHA C OROZCO
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Credential | MT
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Telephone | 954-704-9116
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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 | 800020862
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License Number State | FL
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