Organization
SU-RAJ CORP
Active
Other names
Medical Diagnostic Laboratories
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DILIP MEHTA MS (PRESIDENT)
(856) 786-4222
Entity
Organization
Contact information
Practice address
101 RT 130 S, SUITE 401, CINNAMINSON, NJ 08077
(856) 786-4222
(856) 786-4333
Mailing address
101 RT 130 S, SUITE 401, CINNAMINSON, NJ 08077
(856) 786-4222
(856) 786-4333
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
39DO719734
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5596904
—
NJ
Enumeration date
08/15/2006
Last updated
08/22/2020
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