Organization
IBIS LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J ACHINAPURA PHD (COO)
(561) 588-8323
Entity
Organization
Contact information
Practice address
11350 SW VILLAGE PKWY, PORT ST LUCIE, FL 34987-2352
(561) 588-8323
(561) 275-7998
Mailing address
806 LANTANA RD, LANTANA, FL 33462-1509
(561) 588-8323
(561) 275-7998
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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