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General NPI Number Information
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NPI Number | 1669184305
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Entity Type | Organization
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Legal Business Name | SMART LAB DX, LLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 3500 N STATE ROAD 7 STE 102
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5616
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Country | US
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Telephone | 954-694-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 N STATE ROAD 7 STE 102
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-5616
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Country | US
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Telephone | 954-694-1777
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Fax |
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | MS. TSEHIA MARTINEZ
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Credential |
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Telephone | 954-400-8125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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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 | 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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