Organization
IDEAL LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE D. ESPINAL-MARIOTTE M.D. (PRESIDENT)
(973) 956-3589
Entity
Organization
Contact information
Practice address
307 HAMBURG TPKE, WAYNE, NJ 07470-2142
(973) 956-3589
(975) 720-5733
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
(407) 648-2065
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0003305
NJ
Other
Enumeration date
09/23/2008
Last updated
03/30/2009
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