Provider Demographics
NPI:1841656675
Name:SCIENTIFIC LABORATORY COMPANY LLC
Entity type:Organization
Organization Name:SCIENTIFIC LABORATORY COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-290-4773
Mailing Address - Street 1:3395 LAKE WORTH RD STE 1
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6902
Mailing Address - Country:US
Mailing Address - Phone:561-855-2469
Mailing Address - Fax:561-855-2479
Practice Address - Street 1:3395 LAKE WORTH RD STE 1
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-6902
Practice Address - Country:US
Practice Address - Phone:561-855-2469
Practice Address - Fax:561-855-2479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-09
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory