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General NPI Number Information
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NPI Number | 1710066105
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Entity Type | Organization
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Legal Business Name | SURE RESULTS LABORATORY INC
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7109 SPORTSMANS DR
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-5433
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Country | US
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Telephone | 954-865-4243
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Fax | 954-722-2537
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Provider Business Mailing Address
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Address Line | 7109 SPORTSMANS DR
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-5433
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Country | US
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Telephone | 954-865-4243
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Fax | 954-722-2537
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERRI L MARTINEZ
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Credential |
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Telephone | 954-865-4243
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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 | 321-0003140
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License Number State | FL
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