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General NPI Number Information
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NPI Number | 1891105664
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Entity Type | Organization
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Legal Business Name | PREFERRED LABORATORY LLC
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Dates
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Enumeration Date | 05/02/2014
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 1071 WORCESTER RD FL 4
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5247
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Country | US
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Telephone | 508-459-2190
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Fax | 508-425-4494
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Provider Business Mailing Address
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Address Line | 1071 WORCESTER RD FL 4
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5247
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Country | US
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Telephone | 508-459-2190
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Fax | 508-425-4494
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Authorized Official
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Title or Position | OPERATING MANGER
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Name | ANDREW TINE
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Credential |
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Telephone | 508-459-2190
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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 | 3397
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License Number State | MA
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