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General NPI Number Information
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NPI Number | 1376852780
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Entity Type | Organization
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Legal Business Name | U OF L CYTOGENETICS LABORATORY INC
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Dates
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Enumeration Date | 10/03/2010
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Last Update Date | 10/03/2010
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Provider Practice Location Address
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Address Line | 571 S FLOYD ST STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40202-3818
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Country | US
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Telephone | 866-446-8708
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Fax |
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Provider Business Mailing Address
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Address Line | 9016 TAYLORSVILLE RD STE 129
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City | LOUISVILLE
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State | KY
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Zip | 40299-1750
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Country | US
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Telephone | 866-446-8708
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Fax |
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Authorized Official
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Title or Position | PRESIDNET
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Name | JOSHUA PIERCE
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Credential | M.D.
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Telephone | 866-446-8708
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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 | 18D0648434
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License Number State | KY
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