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General NPI Number Information
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NPI Number | 1861975062
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Entity Type | Organization
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Legal Business Name | EUROFINS CLINICAL MOLECULAR TESTING SERVICES LLC
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Dates
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Enumeration Date | 09/13/2018
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 12701 PLANTSIDE DR
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City | LOUISVILLE
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State | KY
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Zip | 40299-6388
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Country | US
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Telephone | 502-302-6396
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Fax | 502-470-7371
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Provider Business Mailing Address
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Address Line | 12701 PLANTSIDE DR
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City | LOUISVILLE
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State | KY
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Zip | 40299-6388
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Country | US
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Telephone | 502-302-6396
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Fax | 502-470-7371
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Authorized Official
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Title or Position | VP & GENERAL MANAGER
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Name | GREGORY ANTON ENDRESS
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Credential |
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Telephone | 502-302-6396
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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 | 18D2099108
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License Number State | KY
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