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General NPI Number Information
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NPI Number | 1841412525
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Entity Type | Organization
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Legal Business Name | CLEVELAND BIOLOGICALS INC.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 2475 EAST 22ND STREET SUITE 205
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City | CLEVELAND
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State | OH
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Zip | 44115
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Country | US
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Telephone | 216-621-3622
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Fax | 216-621-3711
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Provider Business Mailing Address
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Address Line | 2475 EAST 22ND STREET SUITE 205
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City | CLEVELAND
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State | OH
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Zip | 44115
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Country | US
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Telephone | 216-621-3622
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Fax | 216-621-3711
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARIO J MARKOVIC
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Credential | M.S.
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Telephone | 216-621-6322
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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 | 36D065048
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License Number State | OH
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