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General NPI Number Information
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NPI Number | 1902826381
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Entity Type | Organization
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Legal Business Name | CALLOWAY LABORATORIES INC.
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 12 GILL ST SUITE 4000
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City | WOBURN
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State | MA
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Zip | 01801-1765
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Country | US
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Telephone | 781-224-9899
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Fax | 781-224-2423
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Provider Business Mailing Address
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Address Line | 12 GILL ST SUITE 4000
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City | WOBURN
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State | MA
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Zip | 01801-1765
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Country | US
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Telephone | 781-224-9899
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Fax | 781-224-2423
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Authorized Official
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Title or Position | CEO
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Name | MRS. GAIL MARCUS
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Credential |
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Telephone | 781-224-9899
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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 | 22D107579
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 3294
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License Number State | MA
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