Organization
ST. JUDE LABORATORIES LLC
Active
Organization
ST. JUDE LABORATORIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOSE KALAMPANAYIL (OWNER)
(410) 884-4120
Entity
Organization
Contact information
Practice address
8950 ROUTE 108 STE 121, COLUMBIA, MD 21045-2150
(410) 862-8162
(410) 630-7474
Mailing address
8950 ROUTE 108 STE 121, COLUMBIA, MD 21045-2150
(410) 862-8162
(410) 630-7474
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
MD
Enumeration date
03/08/2019
Last updated
08/29/2025
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