Provider Demographics
NPI:1104123124
Name:PATHLAB SERVICES, LLC
Entity type:Organization
Organization Name:PATHLAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-547-3900
Mailing Address - Street 1:3855 E SILVER SPRINGS BLVD
Mailing Address - Street 2:EXECUTIVE SUITE 500
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-4929
Mailing Address - Country:US
Mailing Address - Phone:352-547-3900
Mailing Address - Fax:352-547-3999
Practice Address - Street 1:3855 E SILVER SPRINGS BLVD
Practice Address - Street 2:EXECUTIVE SUITE 500
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-4929
Practice Address - Country:US
Practice Address - Phone:352-547-3900
Practice Address - Fax:352-547-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800025994291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory