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Organization
MEDILAB INC
Active
Organization
MEDILAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMELIA MESA (AUTHORIZED OFFICIAL)
(305) 588-0106
Entity
Organization
Contact information
Practice address
1860 SE PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34952-5545
(305) 588-0106
Mailing address
1860 SE PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34952-5545
(305) 588-0106
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
NULL
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
03/07/2024
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