Organization
BOCA TOXICOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER LICATA (OWNER)
(954) 729-0222
Entity
Organization
Contact information
Practice address
3280 N FEDERAL HWY, BOCA RATON, FL 33431-6002
(561) 757-5381
(561) 757-5406
Mailing address
7001 N FEDERAL HWY, BOCA RATON, FL 33487-1612
(561) 757-5381
(561) 757-5406
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2103274
CLIA
FL
01
—
26568
COLA
—
Enumeration date
11/10/2015
Last updated
04/23/2019
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