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General NPI Number Information
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NPI Number | 1811325442
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Entity Type | Organization
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Legal Business Name | EXPERTUS LABORATORIES, INC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 1701 GREEN RD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-1074
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Country | US
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Telephone | 407-459-8845
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Fax | 407-459-8845
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Provider Business Mailing Address
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Address Line | 195 WEKIVA SPRINGS RD STE 200
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City | LONGWOOD
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State | FL
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Zip | 32779-3696
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Country | US
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Telephone | 407-375-8599
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Fax | 407-459-8845
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | JASON WEIL
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Credential |
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Telephone | 407-375-8599
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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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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 | FL
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