Organization
1 LAB DIAGNOSTICS NJ LLC
Active
Other names
1lab Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK PAGAN (CEO)
(304) 657-9011
Entity
Organization
Contact information
Practice address
107 GAITHER DR STE B, MOUNT LAUREL, NJ 08054-1730
(724) 570-5852
Mailing address
1044 N US HIGHWAY 1 STE 201, JUPITER, FL 33477-4308
(724) 570-5852
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450896170
NJ DEPARTMENT OF THE TREASURY
NJ
Enumeration date
12/07/2022
Last updated
12/07/2022
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