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General NPI Number Information
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NPI Number | 1952733438
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Entity Type | Organization
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Legal Business Name | EPIC REFERENCE LABS, INC.
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 7960 CENTRAL INDUSTRIAL DR SUITE 120
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-3444
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Country | US
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Telephone | 561-249-4434
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Fax |
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Provider Business Mailing Address
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Address Line | 7960 CENTRAL INDUSTRIAL DR SUITE 120
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-3444
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Country | US
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Telephone | 561-249-4434
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Fax | 561-557-8737
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Authorized Official
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Title or Position | CEO
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Name | SRI BHARAT MADIREDDY
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Credential | PH.D.
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Telephone | 561-249-4317
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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 | 800027064
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License Number State | FL
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