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General NPI Number Information
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NPI Number | 1669609921
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Entity Type | Organization
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Legal Business Name | AXIS DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 825 TOWN CENTER DR STE 148B
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City | LANGHORNE
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State | PA
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Zip | 19047-1793
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Country | US
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Telephone | 267-212-2000
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Fax | 267-212-2005
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Provider Business Mailing Address
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Address Line | 825 TOWN CENTER DR STE 148B
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City | LANGHORNE
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State | PA
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Zip | 19047-1793
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Country | US
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Telephone | 267-212-2000
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Fax | 267-212-2005
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL JOSEPH OLSHAVSKY JR.
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Credential |
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Telephone | 215-622-3480
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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 | 31111
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License Number State | PA
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