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General NPI Number Information
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NPI Number | 1548618408
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Entity Type | Organization
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Legal Business Name | RELIANCE DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 353 US 46 SUITE 215
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City | FAIRFIELD
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State | NJ
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Zip | 07004-2415
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Country | US
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Telephone | 973-276-3213
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Fax |
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Provider Business Mailing Address
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Address Line | 353 US 46 SUITE 215
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City | FAIRFIELD
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State | NJ
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Zip | 07004-2415
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Country | US
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Telephone | 973-276-3213
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIE J BAUDOUIN
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Credential |
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Telephone | 973-441-0958
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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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