MEDICARE: LIMITLESS 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

General Provider Information

NPI Number	:	1548825730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMITLESS DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	3435 BELMONT TER
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-1302
Country	:	US
Telephone Number	:	855-546-1175
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 ALBERIGI DR STE 109
Second Line	:
City	:	JESSUP
State	:	PA
Zip	:	18434-1831
Country	:	US
Telephone Number	:	855-456-1175
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GREGORY AGLE
Credential	:
Telephone Number	:	570-873-0027

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	04/01/2022

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Directions to “LIMITLESS DIAGNOSTICS LLC ” Practice Location

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