Provider Demographics
NPI:1366885618
Name:OPKO LAB, LLC
Entity type:Organization
Organization Name:OPKO LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-874-0410
Mailing Address - Street 1:1450 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-4531
Mailing Address - Country:US
Mailing Address - Phone:615-874-7041
Mailing Address - Fax:615-345-4653
Practice Address - Street 1:326 BARR AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1137
Practice Address - Country:US
Practice Address - Phone:516-569-1841
Practice Address - Fax:615-345-4653
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPKO LAB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-16
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33D2034649291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory