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General NPI Number Information
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NPI Number | 1033734215
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Entity Type | Organization
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Legal Business Name | DOT LABORATORIES, INC.
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 780 E MAIN ST STE 1
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City | BRANFORD
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State | CT
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Zip | 06405-2956
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Country | US
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Telephone | 415-534-9976
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Fax |
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Provider Business Mailing Address
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Address Line | 3749 BUCHANAN ST # 340
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-1710
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HEATHER BOWERMAN
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Credential |
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Telephone | 415-534-9976
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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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