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General NPI Number Information
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NPI Number | 1346218674
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Entity Type | Organization
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Legal Business Name | SUBURBAN MEDICAL LABORATORY, INC.
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Dates
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Enumeration Date | 03/11/2006
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 3575 FOREST LAKE DR #500
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City | UNIONTOWN
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State | OH
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Zip | 44685
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Country | US
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Telephone | 330-628-7500
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Fax | 300-628-7599
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Provider Business Mailing Address
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Address Line | 3575 FOREST LAKE DR #500
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City | UNIONTOWN
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State | OH
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Zip | 44685
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Country | US
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Telephone | 330-628-7500
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Fax | 300-628-7599
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Authorized Official
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Title or Position | DIRECTOR, BILLING
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Name | MS. CINDY SMOTHERMAN
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Credential |
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Telephone | 513-201-1117
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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 | 36D0339673
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License Number State | OH
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