Organization
OCEAN STATE LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOUSTAFA MOATAZ ABOSHADY (SOLE MBR)
(401) 305-7245
Entity
Organization
Contact information
Practice address
1525 OLD LOUISQUISSET PIKE, SUITE 103, LINCOLN, RI 02865-4503
(401) 305-7245
(401) 305-7698
Mailing address
1525 OLD LOUISQUISSET PIKE, SUITE 103, LINCOLN, RI 02865-4503
(401) 305-7245
(401) 305-7698
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/17/2012
Last updated
04/16/2013
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