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NPI Code Detail

MEDICARE: DMT LAB LLC

MEDICARE: DMT LAB LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1255294484
Entity Type Code : Organization
Provider Name (Legal Business Name) : DMT LAB LLC
Provider Business Mailing Address
First Line : 8400 49TH ST N APT 1701
Second Line :
City : PINELLAS PARK
State : FL
Zip : 33781-1549
Country : US
Telephone Number : 859-310-0787
Fax Number :
Provider Business Practice Location Address
First Line : 8400 49TH ST N APT 1701
Second Line :
City : PINELLAS PARK
State : FL
Zip : 33781-1549
Country : US
Telephone Number : 859-310-0787
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MANOJKUMAR N DESAI
Credential :
Telephone Number : 859-310-0787
Provider Enumeration Date : 12/04/2025
Last Update Date : 12/04/2025

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Directions to “DMT LAB LLC ” Practice Location

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