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NPI Code Detail

MEDICARE: COMPLETE LAB & DRUG TEST

MEDICARE: COMPLETE LAB & DRUG TEST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1134528052
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPLETE LAB & DRUG TEST
Provider Business Mailing Address
First Line : PO BOX 247824
Second Line :
City : COLUMBUS
State : OH
Zip : 43224-7824
Country : US
Telephone Number : 614-596-7808
Fax Number : 614-319-5050
Provider Business Practice Location Address
First Line : 4661 CLEVELAND AVE BLDG A
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-5848
Country : US
Telephone Number : 614-269-7612
Fax Number : 614-319-5050
Authorized Official
Title or Position : CEO, CO-FOUNDER
Name : ISMAIL A HASSAN
Credential : MLT(ASCP)
Telephone Number : 614-269-7612
Provider Enumeration Date : 08/15/2014
Last Update Date : 08/15/2014

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Directions to “COMPLETE LAB & DRUG TEST ” Practice Location

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