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General NPI Number Information
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NPI Number | 1962475780
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Entity Type | Organization
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Legal Business Name | HOSPITAL CONSOLIDATED LABORATORIES
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 23775 NORTHWESTERN HWY
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3338
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Country | US
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Telephone | 248-355-9622
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Fax | 248-355-3557
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Provider Business Mailing Address
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Address Line | 22255 GREENFIELD RD SUITE #501
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3710
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Country | US
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Telephone | 248-226-6163
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Fax | 248-424-9844
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | DR. BARRY R. HERSCHMAN
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Credential | M.D.
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Telephone | 248-849-3266
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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 | MI
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