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General NPI Number Information
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NPI Number | 1639590730
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Entity Type | Organization
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Legal Business Name | CENTREX CLIN LABS INC
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 28 CAMPION RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-1602
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Country | US
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Telephone | 315-624-5916
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Fax | 315-724-1300
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Provider Business Mailing Address
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Address Line | 28 CAMPION RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-1602
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Country | US
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Telephone | 315-624-5916
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Fax | 315-724-1300
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Authorized Official
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Title or Position | MANAGER OF AR
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Name | ELIZABETH A PARKER
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Credential |
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Telephone | 315-624-5916
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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 | PFI2205
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License Number State | NY
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