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General NPI Number Information
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NPI Number | 1932589041
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Entity Type | Organization
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Legal Business Name | L&M LAB CORP
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 2960 OCEAN AVE STE 5
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City | BROOKLYN
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State | NY
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Zip | 11235-3286
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Country | US
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Telephone | 718-759-6568
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Fax | 718-759-6569
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Provider Business Mailing Address
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Address Line | 220 DAVIDSON AVE STE 104
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City | SOMERSET
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State | NJ
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Zip | 08873-4144
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Country | US
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Telephone | 718-759-6568
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Fax | 718-759-6569
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Authorized Official
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Title or Position | OWNER
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Name | LOLA NISAN
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Credential |
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Telephone | 718-759-6568
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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 | 33D2077603
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License Number State | NY
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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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