Organization
MY CLINICAL LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN MESA (PRESIDENT)
(954) 530-8460
Entity
Organization
Contact information
Practice address
15481 SW 12TH ST STE 303, SUNRISE, FL 33326-1993
(954) 530-8460
Mailing address
15481 SW 12TH ST STE 303, SUNRISE, FL 33326-1993
(954) 530-8460
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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