Organization
INTERNATIONAL TECHNOLOGIES, LLC
Active
Other names
D/B/A NJ Reference Labs
Organization subpart
No
Provider details
NPI number
Authorized official
SRI BHARAT MADIREDDY PH.D. (C.E.O.)
(561) 249-4317
Entity
Organization
Contact information
Practice address
71 FRANKLIN TPKE, SUITE 1-3, WALDWICK, NJ 07463-1851
(201) 857-3914
(201) 857-3916
Mailing address
71 FRANKLIN TPKE, SUITE 1-3, WALDWICK, NJ 07463-1851
(201) 857-3914
(201) 857-3916
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227812
MEDICARE PTAN
—
01
—
31D2015409
CLIA
—
Enumeration date
09/28/2009
Last updated
12/12/2016
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