Organization
RAVEN LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNA TRIPURANENI MD (PRESIDENT)
(561) 795-3330
Entity
Organization
Contact information
Practice address
1157 S STATE ROAD 7, WELLINGTON, FL 33414-6101
(561) 795-3330
(561) 795-1030
Mailing address
1157 S STATE ROAD 7, WELLINGTON, FL 33414-6101
(561) 795-3330
(561) 795-1030
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
FL
Other
Enumeration date
08/10/2009
Last updated
08/10/2009
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