MEDICARE: FIRST CLASS DIAGNOSTICS 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
1	291U00000X	Clinical Medical Laboratory	800027533	FL

General Provider Information

NPI Number	:	1336533918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CLASS DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	1101 54TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2419
Country	:	US
Telephone Number	:	561-365-3758
Fax Number	:	772-448-4029

Provider Business Practice Location Address
First Line	:	4005 N A1A
Second Line	:
City	:	HUTCHINSON ISLAND
State	:	FL
Zip	:	34949-8524
Country	:	US
Telephone Number	:	561-365-3758
Fax Number	:	772-252-5470

Authorized Official
Title or Position	:	CFO
Name	:	ANNEMARIE SINCAVAGE
Credential	:
Telephone Number	:	561-901-4923

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	09/14/2021

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