Fast Lab Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FAST LAB CORP

Practice address

755 Waverly Ave Ste 100
Holtsville, NY 11742-1125

Phone

(631) 975-7040

Fax

(631) 204-6300

NPI assigned

Jan 4, 2022

Organization subpart

No

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

Authorized official

Name

Syed Muntiqa Shah

Title

Owner

Phone

(973) 997-8787

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1891456695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WAVERLY AVE STE 100",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421125",
            "telephone_number": "631-975-7040",
            "fax_number": "631-204-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WAVERLY AVE STE 100",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421125",
            "telephone_number": "631-975-7040",
            "fax_number": "631-204-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST LAB CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "MUNTIQA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-997-8787"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ever Well Therapy LCSW PLLC
• Ioannis Evgeniou
• Cortney A Evola, ATC
• Sharon Famiglietti
• Farra Isaacson, DDS PLLC
• Tammy Lauren Favaro, AGACNP
• Christine Felice, LPN
• Diana Feliciano
• Victor Feliciano
• Yesika Fernandez

• Clinical Medical Laboratory in Holtsville, NY
• Providers in Holtsville, NY by specialty
• Clinical Medical Laboratory in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.