Organization
L&M LAB CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOLA NISAN (OWNER)
(718) 759-6568
Entity
Organization
Contact information
Practice address
220 DAVIDSON AVE STE 104, SOMERSET, NJ 08873-4144
(718) 759-6568
Mailing address
220 DAVIDSON AVE STE 104, SOMERSET, NJ 08873-4144
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33D2077603
CLIA
NJ
Enumeration date
03/22/2022
Last updated
03/22/2022
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