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General NPI Number Information
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NPI Number | 1427133685
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CLINICAL LABORATORIES
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 12/11/2018
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Provider Practice Location Address
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Address Line | 1526 PEACH ST
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City | ERIE
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State | PA
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Zip | 16501-2110
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Country | US
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Telephone | 814-461-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S COLLEGEVILLE RD
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-2998
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Country | US
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Telephone | 866-697-8378
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIEL W GARTLAND
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Credential |
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Telephone | 814-461-2400
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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 | 39D0183896
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License Number State | PA
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