1841741808 NPI number — BIOREFERENCE HEALTH, LLC

Table of content: (NPI 1841741808)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841741808 NPI number — BIOREFERENCE HEALTH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIOREFERENCE HEALTH, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BIO-REFERENCE LABORATORIES, INC.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841741808
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
481 EDWARD H ROSS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELMWOOD PARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07407-3118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-791-2600
Provider Business Mailing Address Fax Number:
201-791-1941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3401 WINONA AVE UNIT 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURBANK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91504-2549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-229-5227
Provider Business Practice Location Address Fax Number:
201-663-6585
Provider Enumeration Date:
10/14/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SCHMID
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP, CHIEF LEGAL OFFICER
Authorized Official Telephone Number:
201-791-2600

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05D2117497 . This is a "CLIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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