Organization
GUARDIAN CLINICAL LABORATORIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELIAS J KHABBAZA PH.D. (LABORATORY DIRECTOR)
(631) 424-1807
Entity
Organization
Contact information
Practice address
232 E MAIN ST, SUITE 1, HUNTINGTON, NY 11743-2920
(631) 424-1807
(631) 424-0762
Mailing address
232 E MAIN ST, SUITE 1, HUNTINGTON, NY 11743-2920
(631) 424-1807
(631) 424-0762
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
7402
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568483535
RAIL ROAD MEDICARE
—
01
—
94249
VYTRA
NY
01
—
A1235192
OXFORD
NY
01
—
N45663
HEALTHNET
NY
Enumeration date
07/22/2006
Last updated
09/29/2015
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