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General NPI Number Information
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NPI Number | 1396568168
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Entity Type | Organization
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Legal Business Name | INNOVATIVE LABS OF SFL
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 1710 NE 2ND TER
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City | POMPANO BEACH
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State | FL
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Zip | 33060-5222
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Country | US
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Telephone | 954-859-4030
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 NE 2ND TER
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City | POMPANO BEACH
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State | FL
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Zip | 33060-5222
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Country | US
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Telephone | 954-859-4030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JASMINE NOEL
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Credential |
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Telephone | 954-859-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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