Provider Demographics
NPI:1760220032
Name:PRO-HEALTH LABS
Entity type:Organization
Organization Name:PRO-HEALTH LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAINOR
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, MT
Authorized Official - Phone:201-370-3260
Mailing Address - Street 1:7012 PARK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-4708
Mailing Address - Country:US
Mailing Address - Phone:201-370-3260
Mailing Address - Fax:
Practice Address - Street 1:7012 PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-4708
Practice Address - Country:US
Practice Address - Phone:201-370-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology
No246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory ManagementGroup - Multi-Specialty
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service