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General NPI Number Information
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NPI Number | 1548279227
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Entity Type | Organization
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Legal Business Name | UNITED LABORATORY SERVICE,CORP
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 7095 SW 47TH ST BLDG B
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City | MIAMI
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State | FL
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Zip | 33155-4653
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Country | US
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Telephone | 305-269-0121
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Fax | 305-269-4941
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Provider Business Mailing Address
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Address Line | 7095 SW 47 STREET STE B
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City | MIAMI
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State | FL
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Zip | 33155
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Country | US
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Telephone | 305-269-0121
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Fax | 305-269-4941
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Authorized Official
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Title or Position | PRESIDENT
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Name | IDALMA M HAIDAR
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Credential |
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Telephone | 305-269-0121
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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 | 800020757
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License Number State | FL
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