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General NPI Number Information
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NPI Number | 1154718930
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Entity Type | Organization
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Legal Business Name | BG LABORATORY, INC
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 600 W DIVISION ST
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City | DOVER
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State | DE
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Zip | 19904-2702
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Country | US
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Telephone | 888-398-8841
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Fax |
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Provider Business Mailing Address
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Address Line | 600 W DIVISION ST
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City | DOVER
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State | DE
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Zip | 19904-2702
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Country | US
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Telephone | 888-398-8841
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Fax |
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Authorized Official
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Title or Position | CEO/LABORATORY DIRECTOR
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Name | DR. KIMBERLY MILLIGAN
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Credential | PHD
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Telephone | 888-398-8841
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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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