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General NPI Number Information
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NPI Number | 1679228191
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Entity Type | Organization
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Legal Business Name | CAPTURE DIAGNOSTICS, HIB01 LLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 1950 N KING ST
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City | HONOLULU
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State | HI
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Zip | 96819-3453
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Country | US
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Telephone | 855-855-6407
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 KINNEAR RD
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City | COLUMBUS
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State | OH
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Zip | 43212-1166
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Country | US
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Telephone | 702-576-1904
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | MR. DAVID MORITZ
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Credential |
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Telephone | 702-576-1904
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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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