Organization
SUNRISE CLINICAL LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIFTAH KEMAL (OWNER)
(941) 624-3005
Entity
Organization
Contact information
Practice address
21216 OLEAN BLVD, STE 3, PORT CHARLOTTE, FL 33952-6722
(941) 624-3005
(941) 624-6405
Mailing address
21216 OLEAN BLVD, STE 3, PORT CHARLOTTE, FL 33952-6722
(941) 624-3005
(941) 624-6405
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800019331
FL
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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