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General NPI Number Information
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NPI Number | 1265182000
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Entity Type | Organization
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Legal Business Name | ALLIED LAB SERVICES, LLC
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 2942 COOPERLAND CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-5034
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Country | US
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Telephone | 317-523-5668
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 781213
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City | INDIANAPOLIS
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State | IN
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Zip | 46278-8213
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Country | US
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Telephone | 317-523-5668
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MICHELLE MATTINGLY
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Credential |
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Telephone | 317-523-5668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QL0901X
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Taxonomy Name | Diplomate Laboratory Management Specialist/Technologist
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License Number |
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License Number State |
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