Healthcare Provider Details

I. General information

NPI: 1528255155
Provider Name (Legal Business Name): DCL MEDICAL LABORATORIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9550 ZIONSVILLE RD
INDIANAPOLIS IN
46268-1065
US

IV. Provider business mailing address

PO BOX 2240
BURLINGTON NC
27216-2240
US

V. Phone/Fax

Practice location:
  • Phone: 800-377-9364
  • Fax:
Mailing address:
  • Phone: 800-222-7566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY WILLIAMS
Title or Position: VP
Credential:
Phone: 800-222-7566