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General NPI Number Information
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NPI Number | 1073587937
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Entity Type | Organization
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Legal Business Name | JOINT VENTURE HOSPITAL LABORATORIES
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 999 REPUBLIC DRIVE, SUITE 300
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City | ALLEN PARK
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State | MI
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Zip | 48101
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Country | US
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Telephone | 313-271-3692
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Fax | 313-441-1668
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Provider Business Mailing Address
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Address Line | 999 REPUBLIC DRIVE, SUITE 300
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City | ALLEN PARK
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State | MI
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Zip | 48101
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Country | US
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Telephone | 313-271-3692
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Fax | 313-441-1668
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JOHN KOLOZSVARY
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Credential |
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Telephone | 313-271-3692
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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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