Elite Diagnostic Laboratories, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

291U00000X Issued in FL

Legal business name

ELITE DIAGNOSTIC LABORATORIES, LLC

Practice address

4111 SW 47 TH Ave
Suite 331
Davie, FL 33314-4026

Phone

(954) 584-8848

Fax

(954) 584-8850

NPI assigned

Dec 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eriberto Torres

Title

Owner/Secretary

Phone

(954) 584-8848

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1851536973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 SW 47TH AVE",
            "address_2": "SUITE 331",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144026",
            "telephone_number": "954-584-8848",
            "fax_number": "954-584-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 SW 47 TH AVE",
            "address_2": "SUITE 331",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144026",
            "telephone_number": "954-584-8848",
            "fax_number": "954-584-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTIC LABORATORIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "ERIBERTO",
        "authorized_official_title_or_position": "OWNER/SECRETARY",
        "authorized_official_telephone_number": "954-584-8848"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "291U00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Davie, FL
• Providers in Davie, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.