Provider Demographics
NPI:1104586767
Name:COVID TESTING LABS LLC
Entity type:Organization
Organization Name:COVID TESTING LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:SARRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:725-240-0608
Mailing Address - Street 1:3737 PECOS MCLEOD INTERCONNECT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4262
Mailing Address - Country:US
Mailing Address - Phone:725-240-0608
Mailing Address - Fax:888-356-3518
Practice Address - Street 1:3737 PECOS MCLEOD INTERCONNECT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4262
Practice Address - Country:US
Practice Address - Phone:725-240-0608
Practice Address - Fax:888-356-3518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory