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General NPI Number Information
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NPI Number | 1124117890
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Entity Type | Organization
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Legal Business Name | CLINICAL SCIENCE LABORATORY INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 51 FRANCIS AVE
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City | MANSFIELD
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State | MA
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Zip | 02048-1511
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Country | US
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Telephone | 508-339-6106
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Fax | 508-339-3540
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Provider Business Mailing Address
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Address Line | PO BOX 347
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City | MANSFIELD
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State | MA
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Zip | 02048-0347
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Country | US
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Telephone | 508-339-6106
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Fax | 508-339-3540
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STANLEY G ELFBAUM
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Credential | PH.D
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Telephone | 508-339-6106
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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 | 5488
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License Number State | MA
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