MEDICARE: BAYER REFERENCE TESTING LABORATORY

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
1	291U00000X	Clinical Medical Laboratory	CLF10781	CA
2	291U00000X	Clinical Medical Laboratory	733	MD
3	291U00000X	Clinical Medical Laboratory	PFI4995	NY
4	291U00000X	Clinical Medical Laboratory	023005	PA
5	291U00000X	Clinical Medical Laboratory	LC000312	RI
6	291U00000X	Clinical Medical Laboratory	HIV-RL-23	WV
7	291U00000X	Clinical Medical Laboratory	50355	CA
8	291U00000X	Clinical Medical Laboratory	LEO22797-0	CA
9	291U00000X	Clinical Medical Laboratory		CA
10	291U00000X	Clinical Medical Laboratory		FL
11	291U00000X	Clinical Medical Laboratory		CA

General Provider Information

NPI Number	:	1235114067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYER REFERENCE TESTING LABORATORY

Provider Business Mailing Address
First Line	:	725 POTTER ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2722
Country	:	US
Telephone Number	:	510-705-5900
Fax Number	:	510-705-5902

Provider Business Practice Location Address
First Line	:	725 POTTER ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2722
Country	:	US
Telephone Number	:	510-705-5900
Fax Number	:	510-705-5902

Authorized Official
Title or Position	:	BRTL MEDICAL DIRECTOR
Name	:	DR. WILLIAM PATRICK JOSEPH
Credential	:	M.D.
Telephone Number	:	510-705-5900

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	08/22/2020

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Directions to “BAYER REFERENCE TESTING LABORATORY ” Practice Location

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