Organization
FLORIDA MEDICAL STAT LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID STUART GERREN BA,MS (LABORATORY MANAGER)
(954) 933-2439
Entity
Organization
Contact information
Practice address
7660 N NOB HILL RD, TAMARAC, FL 33321-1843
(954) 933-2439
Mailing address
7660 N NOB HILL RD, TAMARAC, FL 33321-1843
(954) 933-2439
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
NOT ISSUED YET
FL
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269842100
FILE NUMBER FOR AHCA
FL
Enumeration date
06/17/2011
Last updated
06/17/2011
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