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General NPI Number Information
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NPI Number | 1639379738
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Entity Type | Organization
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Legal Business Name | LABORATORY ACQUISITION COMPANY PC
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 225B WINTON M BLOUNT LOOP
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City | MONTGOMERY
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State | AL
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Zip | 36117-3507
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Country | US
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Telephone | 334-263-6228
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Fax | 334-265-9136
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Provider Business Mailing Address
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Address Line | 225B WINTON M BLOUNT LOOP
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City | MONTGOMERY
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State | AL
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Zip | 36117-3507
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Country | US
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Telephone | 334-263-6228
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Fax | 334-265-9136
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JANICE BLEVINS
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Credential |
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Telephone | 334-263-6228
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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 | 9178
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License Number State | AL
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