Provider Demographics
NPI:1891456695
Name:FAST LAB CORP
Entity type:Organization
Organization Name:FAST LAB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:MUNTIQA
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-997-8787
Mailing Address - Street 1:755 WAVERLY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1125
Mailing Address - Country:US
Mailing Address - Phone:631-975-7040
Mailing Address - Fax:631-204-6300
Practice Address - Street 1:755 WAVERLY AVE STE 100
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1125
Practice Address - Country:US
Practice Address - Phone:631-975-7040
Practice Address - Fax:631-204-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory