Organization
PRATT MEDICAL CENTER LTD
Active
Other names
Pratt Healthcare Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT WALKER (PRESIDENT)
(540) 345-3556
Entity
Organization
Contact information
Practice address
1451 HOSPITAL DR, FREDERICKSBURG, VA 22401-8424
(540) 785-7850
(540) 786-3435
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
49D0224890
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004980794
—
VA
01
—
49D0224890
CLIA
VA
01
—
690498079
MEDICARE GROUP
VA
Enumeration date
07/10/2006
Last updated
07/17/2019
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