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General NPI Number Information
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NPI Number | 1356735476
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Entity Type | Organization
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Legal Business Name | QUALITY LAB LLC.
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 5427 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-1110
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Country | US
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Telephone | 352-584-7452
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Fax |
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Provider Business Mailing Address
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Address Line | 5427 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-1110
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Country | US
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Telephone | 352-584-7452
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MIRZA BAIG
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Credential |
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Telephone | 352-584-7452
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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 | 10D2090296
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License Number State | FL
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