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General NPI Number Information
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NPI Number | 1659817849
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Entity Type | Organization
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Legal Business Name | LABORATORY ASSOCIATES OF ERIE LLC
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Dates
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Enumeration Date | 01/11/2017
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 100 PEACH ST SUITE 202
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City | ERIE
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State | PA
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Zip | 16507-1423
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Country | US
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Telephone | 814-459-1851
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Fax | 814-456-0541
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Provider Business Mailing Address
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Address Line | 100 PEACH ST SUITE 202
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City | ERIE
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State | PA
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Zip | 16507-1423
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Country | US
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Telephone | 814-459-1851
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Fax | 814-456-0541
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Authorized Official
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Title or Position | MD/LABORATORY DIRECTOR
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Name | MICHAEL A SCUTELLA
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Credential |
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Telephone | 814-459-1851
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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 | 39D0679874
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License Number State | PA
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