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General NPI Number Information
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NPI Number | 1013336619
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Entity Type | Organization
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Legal Business Name | LCDC, LLC
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 3641 JUNIATA ST
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City | SAINT LOUIS
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State | MO
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Zip | 63116-4809
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Country | US
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Telephone | 866-873-0879
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Fax | 314-762-0233
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Provider Business Mailing Address
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Address Line | 3641 JUNIATA ST
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City | SAINT LOUIS
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State | MO
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Zip | 63116-4809
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Country | US
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Telephone | 866-873-0879
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Fax | 314-762-0233
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIONS
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Name | MRS. CHRISTI ZALMANOFF
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Credential |
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Telephone | 314-269-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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