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General NPI Number Information
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NPI Number | 1598231045
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Entity Type | Organization
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Legal Business Name | NATIONWIDE LABORATORIES, LLC
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Dates
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Enumeration Date | 10/22/2018
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Last Update Date | 10/22/2018
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Provider Practice Location Address
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Address Line | 1307 ALLEN DR STE A300
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City | TROY
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State | MI
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Zip | 48083-4000
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Country | US
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Telephone | 855-698-2941
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Fax | 888-392-6043
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Provider Business Mailing Address
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Address Line | 1307 ALLEN DR STE A300
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City | TROY
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State | MI
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Zip | 48083-4000
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Country | US
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Telephone | 855-698-2941
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Fax | 888-392-6043
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | ELIZABETH THOMPSON
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Credential |
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Telephone | 503-593-8601
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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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