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General NPI Number Information
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NPI Number | 1528281235
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Entity Type | Organization
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Legal Business Name | ATHENS MEDICAL LABORATORY ASSOCIATES, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 400 EAST STATE STREET
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City | ATHENS
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State | OH
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Zip | 45701
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Country | US
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Telephone | 740-593-8240
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Fax | 740-592-5718
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Provider Business Mailing Address
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Address Line | 400 EAST STATE STREET
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City | ATHENS
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State | OH
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Zip | 45701
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Country | US
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Telephone | 740-593-8240
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Fax | 740-592-5718
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | DR. SCOTT JENKINSON
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Credential | D.O.
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Telephone | 740-593-8240
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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 | 36D035113
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License Number State | OH
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Taxonomy #2
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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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