Organization
TOTAL LAB CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED S HUSSAIN MD (PRESIDENT)
(904) 647-7404
Entity
Organization
Contact information
Practice address
7685 103RD ST, SUITE A1, JACKSONVILLE, FL 32210-9325
(904) 647-7404
(904) 394-5115
Mailing address
7685 103RD ST, SUITE A1, JACKSONVILLE, FL 32210-9325
(904) 647-7404
(904) 394-5115
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800027316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2077557
CLIA ID NUMBER
FL
01
—
800027316
ACHA LICENSE
FL
Enumeration date
10/22/2014
Last updated
10/22/2014
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