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NPI Code Detail

MEDICARE: SYBRO DIAGNOSTICS LLC

MEDICARE: SYBRO 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1649136839
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYBRO DIAGNOSTICS LLC
Provider Business Mailing Address
First Line : 2011 STATE ROUTE 9 , LAKE GEORGE, NY 12845
Second Line :
City : LAKE GEORGE
State : NY
Zip : 12845-4003
Country : US
Telephone Number : 518-920-8282
Fax Number :
Provider Business Practice Location Address
First Line : 10443 N CAVE CREEK RD STE 105
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-1617
Country : US
Telephone Number : 518-920-8282
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SYED IMRAN ALI SHAH
Credential :
Telephone Number : 518-920-8282
Provider Enumeration Date : 12/31/2025
Last Update Date : 03/03/2026

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Directions to “SYBRO DIAGNOSTICS LLC ” Practice Location

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