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Organization

G. CROSS MEDICAL LABS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JACOB JOSEPH KALLUPURA ESQ. (PRESIDENT/CEO)
(781) 864-1391
Entity
Organization

Contact information

Practice address
2901 N DALE MABRY HWY, #612, TAMPA, FL 33607-2412
(781) 864-1391
Mailing address
17945 HUNTING BOW CIR, #101, LUTZ, FL 33558-5376
(781) 864-1391

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D2097893
FL

Other

Enumeration date
08/12/2016
Last updated
08/12/2016
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