1922939990 NPI number — GUESS PREMIER COLLECTION AND LAB SERVICES LLC

Table of content: (NPI 1922939990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922939990 NPI number — GUESS PREMIER COLLECTION AND LAB SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUESS PREMIER COLLECTION AND LAB SERVICES 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:
Provider Other Organization Name Type Code:
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:
1922939990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
78 JOHN MILLER WAY STE 326
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEARNY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07032-6533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-899-1684
Provider Business Mailing Address Fax Number:
888-261-8966

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
139 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-899-1684
Provider Business Practice Location Address Fax Number:
888-261-8966
Provider Enumeration Date:
05/27/2026

Additional Information

Authorized Official

Authorized Official Last Name:
DUREN
Authorized Official First Name:
JAKIRAH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND HEAD SPECIMEN COLLECT
Authorized Official Telephone Number:
908-899-1684

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: 31D2343538 . This is a "CLIA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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