Organization
STATLAB MOBILE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHEVERAL DEACON ASPT (PRESIDENT)
(305) 491-3809
Entity
Organization
Contact information
Practice address
19101 SW 108TH AVE UNIT 4, CUTLER BAY, FL 33157-6783
(844) 469-5227
Mailing address
19101 SW 108TH AVE UNIT 4, CUTLER BAY, FL 33157-6783
(844) 469-5227
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016241900
—
FL
Enumeration date
11/03/2013
Last updated
05/10/2017
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