Organization
SPARK INSPIRATION LABORATORY, LLC
Active
Other names
Spark Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
ZOWIE MARCANO (CHIEF OPERATING OFFICER)
(862) 571-6906
Entity
Organization
Contact information
Practice address
37 W CENTURY RD, SUITE 100A, PARAMUS, NJ 07652-1466
(862) 571-6906
Mailing address
37 W CENTURY RD, SUITE 100A, PARAMUS, NJ 07652-1466
(862) 208-9876
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0732290
—
NJ
Enumeration date
06/22/2018
Last updated
04/09/2025
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