Provider Demographics
NPI:1265300917
Name:BIOTRUST LABS INC
Entity type:Organization
Organization Name:BIOTRUST LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-997-0164
Mailing Address - Street 1:1001 NW 62ND ST STE 105A
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1947
Mailing Address - Country:US
Mailing Address - Phone:954-997-0164
Mailing Address - Fax:
Practice Address - Street 1:1001 NW 62ND ST STE 105A
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1947
Practice Address - Country:US
Practice Address - Phone:954-997-0164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-24
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory