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General NPI Number Information
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NPI Number | 1306350194
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Entity Type | Organization
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Legal Business Name | MEDICAL LABORATORY SERVICE INC
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Dates
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Enumeration Date | 12/01/2017
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 2324 BROOKLYN RD
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City | JACKSON
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State | MI
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Zip | 49203-4750
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Country | US
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Telephone | 517-997-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 31700 W 13 MILE RD # 218
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2166
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Country | US
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Telephone | 248-907-3985
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MARY IOCCA-SMITH
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Credential |
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Telephone | 517-206-7267
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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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