Organization
EXCELSIOR DIAGNOSTIC LABORATORIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRFAN S CHAUDHRY (PRESIDENT)
(917) 364-9486
Entity
Organization
Contact information
Practice address
2720 ROUTE 27, NORTH BRUNSWICK, NJ 08902-1029
(718) 702-7843
Mailing address
2720 ROUTE 27, NORTH BRUNSWICK, NJ 08902-1029
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
00041703
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008740
CLIS
NJ
Enumeration date
04/14/2016
Last updated
11/16/2022
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