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General NPI Number Information
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NPI Number | 1417370651
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Entity Type | Organization
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Legal Business Name | NATIONAL LABORATORIES, LLC
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 1411 SE OCEAN AVENUE
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City | STUART
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State | FL
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Zip | 34996
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Country | US
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Telephone | 772-678-3927
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Fax | 772-266-9429
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Provider Business Mailing Address
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Address Line | PO BOX 733202
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City | DALLAS
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State | TX
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Zip | 75373-3202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | BRENDAN CONLAN
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Credential |
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Telephone | 772-872-6025
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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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