# ANGIOGRAPHIC LABORATORY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cardiac-Vascular Diagnostic Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134210297
- **Authorized official:** BRYAN L FREDERICKS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (330) 375-3812

## Contact information

- **Practice address:** 95 ARCH ST, SUITE 115, AKRON, OH 44304-1437
- **Practice address phone:** (330) 375-6520
- **Practice address fax:** (330) 375-6521
- **Mailing address:** 95 ARCH ST, SUITE 115, AKRON, OH 44304-1437
- **Mailing address phone:** (330) 375-6520
- **Mailing address fax:** (330) 375-6521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2480337 | — | OH |