Impak Diagnostics Laboratory 'LLC'

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IMPAK DIAGNOSTICS LABORATORY 'LLC'

Practice address

5885 Margate Blvd
Margate, FL 33063-2834

Phone

(631) 482-5388

NPI assigned

Oct 30, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Shubert Pierre

Title

Director

Phone

(631) 482-5388

Specialties & licenses 1

Addresses

Other names 1

• IMPAK DIAGNOSTICS LABORATORY 'LLC' Doing business as

Locations

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1962002501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 GOVERNORS CT",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334187161",
            "telephone_number": "631-482-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 MARGATE BLVD",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330632834",
            "telephone_number": "631-482-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPAK DIAGNOSTICS LABORATORY 'LLC'",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "PIERRE",
        "authorized_official_first_name": "SHUBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-482-5388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMPAK DIAGNOSTICS LABORATORY 'LLC'",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Margate, FL
• Providers in Margate, 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 Oct 30, 2020; 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.