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Organization

CENTRAL REGIONAL PATHOLOGY LABORATORIES PA

Active
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Organization

CENTRAL REGIONAL PATHOLOGY LABORATORIES PA

Active
Other names
University Park Pathologists
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE LEMIEUX (BUSINESS OFFICE MANAGER)
(651) 264-1521
Entity
Organization

Contact information

Practice address
2945 HAZELWOOD STREET, SUITE 310, MAPLEWOOD, MN 55109-1244
(651) 264-1521
(651) 264-1661
Mailing address
2945 HAZELWOOD STREET, SUITE 310, MAPLEWOOD, MN 55109
(651) 264-1521
(651) 264-1661

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
PF169
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01224
UPP MEDICARE GRP
MN
Enumeration date
05/15/2006
Last updated
06/04/2024
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