Provider Demographics
NPI:1285957951
Name:PB LABORATORIES LLC
Entity type:Organization
Organization Name:PB LABORATORIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-855-1626
Mailing Address - Street 1:7451 S MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7800
Mailing Address - Country:US
Mailing Address - Phone:561-641-9024
Mailing Address - Fax:561-641-9025
Practice Address - Street 1:7451 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-7800
Practice Address - Country:US
Practice Address - Phone:561-641-9024
Practice Address - Fax:561-641-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800025714291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory