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General NPI Number Information
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NPI Number | 1578619029
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC LABORATORY SERVICES, PLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1500 E SHERMAN BLVD
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City | MUSKEGON
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State | MI
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Zip | 49444-1849
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Country | US
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Telephone | 231-739-3911
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 E SHERMAN BLVD
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City | MUSKEGON
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State | MI
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Zip | 49444-1849
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Country | US
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Telephone | 231-739-3911
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. RICHARD PETERS
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Credential | M.D.
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Telephone | 231-739-3911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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