Healthcare Provider Details

I. General information

NPI: 1427384304
Provider Name (Legal Business Name): BURLINGTON LABORATORIES OF SARATOGA COUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SPRING ST
SCHUYLERVILLE NY
12871-1049
US

IV. Provider business mailing address

12 SPRING ST
SCHUYLERVILLE NY
12871-1049
US

V. Phone/Fax

Practice location:
  • Phone: 518-695-3200
  • Fax: 518-695-3230
Mailing address:
  • Phone: 518-695-3200
  • Fax: 518-695-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number8451
License Number StateNY

VIII. Authorized Official

Name: MR. MICHAEL CASARICO
Title or Position: PRESIDENT
Credential:
Phone: 802-863-4105