Organization
MEDICAL DIAGNOSTIC LABORATORIES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELI MORDECHAI PHD (CHIEF EXECUTIVE OFFICER)
(877) 269-0090
Entity
Organization
Contact information
Practice address
2439 KUSER RD, HAMILTON, NJ 08690-3303
(877) 269-0090
(609) 570-1050
Mailing address
2439 KUSER RD, HAMILTON, NJ 08690-3303
(877) 269-0090
(609) 570-1050
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0000875
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000100331
—
VA
05
—
00126252
—
MS
05
—
009995390
—
AL
05
—
030726200
—
FL
05
—
036782400
—
DC
05
—
0421260
—
MT
05
—
044982200
—
MN
05
—
0569350
—
IA
05
—
1000024322
—
DE
05
—
100250923-00
—
NE
05
—
100504421
—
NV
05
—
1010108
—
VT
05
—
1014034040001
—
PA
05
—
1130877
—
LA
05
—
121654600
—
WY
05
—
147734101
—
TX
05
—
152606709
—
AR
05
—
1575189
—
AK
05
—
164514825
—
MI
05
—
165950000
—
ME
05
—
1750373908
—
CA
05
—
200297200A
—
KS
05
—
200425980A
—
IN
05
—
2396045
—
OH
05
—
241804
—
OR
05
—
30803540
—
NH
05
—
32939800
—
WI
05
—
37000551
—
KY
05
—
401835400
—
MD
05
—
4490734
—
TN
05
—
47927763
—
NM
05
—
539994613A
—
GA
05
—
57875332
—
CO
05
—
6703060000
—
WV
05
—
7001238
—
NC
05
—
706037900
—
MO
05
—
7119282
—
WA
05
—
7512406
—
NJ
05
—
775398
—
AZ
05
—
806585600
—
ID
05
—
L00157
—
SC
05
—
XXXXXXXXX
—
IL
Enumeration date
08/15/2005
Last updated
08/29/2022
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