Provider Demographics
NPI:1053920157
Name:LAB TEST 4 U
Entity type:Organization
Organization Name:LAB TEST 4 U
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CT SPECIMENCOLLECTOR
Authorized Official - Phone:954-662-8603
Mailing Address - Street 1:8367 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-613-5931
Mailing Address - Fax:954-799-5951
Practice Address - Street 1:8367 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-613-5931
Practice Address - Fax:954-799-5951
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREFERRED HEALTH INSURANCE/DBA LAB TEST 4 U
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-24
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZC0008XAllopathic & Osteopathic PhysiciansPathologyClinical InformaticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNONEOtherNONE