Organization
MAINSTREAM DIAGNOSTIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAINELLYS VILLACIS (PRESIDENT)
(786) 718-4002
Entity
Organization
Contact information
Practice address
5354 GULF DR, NEW PORT RICHEY, FL 34652-3920
(727) 203-8391
Mailing address
5354 GULF DR, NEW PORT RICHEY, FL 34652-3920
(727) 203-8391
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
01/27/2020
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