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General NPI Number Information
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NPI Number | 1922386325
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Entity Type | Organization
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Legal Business Name | DCL PATHOLOGY LLC
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 9550 ZIONSVILLE RD SUITE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1065
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Country | US
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Telephone | 317-874-1254
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Fax | 317-872-4193
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Provider Business Mailing Address
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Address Line | 9550 ZIONSVILLE RD SUITE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1065
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Country | US
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Telephone | 317-874-1254
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Fax | 317-872-4193
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | DR. MARY CAROL EISENHUT
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Credential | MD
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Telephone | 317-874-1254
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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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