Organization
LAB SOURCE ONE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANISLAV GRINBERG PHD (LAB DIRECTOR)
(929) 539-6804
Entity
Organization
Contact information
Practice address
132 32ND ST STE 210, BROOKLYN, NY 11232-1833
(929) 539-6804
Mailing address
132 32ND ST STE 210, BROOKLYN, NY 11232-1833
(929) 539-6804
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
09/27/2022
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