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General NPI Number Information
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NPI Number | 1124038930
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Entity Type | Organization
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Legal Business Name | MERIDIAN CLINICAL LABORATORY, CORP
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 300 SW 107TH AVE SUITE 209
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City | MIAMI
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State | FL
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Zip | 33174-3600
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Country | US
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Telephone | 305-554-9790
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Fax | 305-228-8387
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Provider Business Mailing Address
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Address Line | 481 EDWARD H ROSS DR SUITE 209
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-3118
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Country | US
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Telephone | 201-791-2600
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Fax | 201-791-1941
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Authorized Official
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Title or Position | COO; EXECUTIVE VP
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Name | MR. WARREN W ERDMANN
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Credential |
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Telephone | 201-791-2600
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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 | 800015640
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License Number State | FL
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