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NPI Code Detail

MEDICARE: CONSOLIDATED LABORATORY SERVICES INC

MEDICARE: CONSOLIDATED LABORATORY SERVICES INC
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 Laboratory1944LIC-3NV

General Provider Information

NPI Number : 1952382400
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONSOLIDATED LABORATORY SERVICES INC
Provider Business Mailing Address
First Line : 4275 BURNHAM AVE
Second Line : SUITE 325
City : LAS VEGAS
State : NV
Zip : 89119-5488
Country : US
Telephone Number : 702-933-4522
Fax Number : 702-932-5271
Provider Business Practice Location Address
First Line : 4275 BURNHAM AVE
Second Line : SUITE 325
City : LAS VEGAS
State : NV
Zip : 89119-5488
Country : US
Telephone Number : 702-933-4522
Fax Number : 702-932-5271
Authorized Official
Title or Position : LAB DIRECTOR
Name : MR. ALEXANDER STOJANOFF
Credential : PHD
Telephone Number : 702-933-4522
Provider Enumeration Date : 11/10/2005
Last Update Date : 08/22/2020

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Directions to “CONSOLIDATED LABORATORY SERVICES INC ” Practice Location

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