Organization
BUENA VISTA LABS LLC
Active
Organization
BUENA VISTA LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERITA N CHANG (MANAGER)
(954) 993-2040
Entity
Organization
Contact information
Practice address
25K OLYMPIA AVE, WOBURN, MA 01801-7245
(781) 904-3130
(954) 990-6305
Mailing address
759 CHIEF JUSTICE CUSHING HWY STE 359, COHASSET, MA 02025-2115
(954) 990-6305
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22D2227755
CLIA
MA
Enumeration date
09/15/2021
Last updated
01/17/2022
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