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NPI Code Detail

MEDICARE: ALABAMA CHD LABORATORY SYSTEM

MEDICARE: ALABAMA CHD LABORATORY SYSTEM
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 : 1609116441
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALABAMA CHD LABORATORY SYSTEM
Provider Business Mailing Address
First Line : 8140 UNIVERSITY DR
Second Line :
City : MONTGOMERY
State : AL
Zip : 36130-9998
Country : US
Telephone Number : 334-260-3400
Fax Number :
Provider Business Practice Location Address
First Line : 8140 UNIVERSITY DR
Second Line :
City : MONTGOMERY
State : AL
Zip : 36130-9998
Country : US
Telephone Number : 334-260-3400
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF HEALTH SYSTEMS
Name : REGINA PATTERSON
Credential :
Telephone Number : 334-206-5061
Provider Enumeration Date : 02/14/2013
Last Update Date : 02/14/2013

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Directions to “ALABAMA CHD LABORATORY SYSTEM ” Practice Location

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