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General NPI Number Information
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NPI Number | 1093879140
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Entity Type | Organization
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Legal Business Name | DCL MEDICAL LABORATORIES, LLC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 1616 EAST PORT PLAZA
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City | COLLINSVILLE
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State | IL
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Zip | 62234
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Country | US
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Telephone | 618-343-0002
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Fax | 317-874-1440
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Provider Business Mailing Address
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Address Line | 9550 ZIONSVILLE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1065
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Country | US
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Telephone | 317-874-1319
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Fax | 317-874-1440
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MR. JAMES A BUCHER
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Credential |
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Telephone | 317-874-1297
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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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