Organization
SKIPPACK CLINICAL LAB
Active
Other names
Skippack Medical Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HASU B AMIN MS ASCP (LAB SUPERVISOR)
(610) 584-1669
Entity
Organization
Contact information
Practice address
3887 SKIPPACK PIKE, SKIPPACK, PA 19474-0817
(610) 584-1669
(610) 584-5188
Mailing address
PO BOX 817, 3887 SKIPPACK PIKE, SKIPPACK, PA 19474-0817
(610) 584-1669
(610) 584-5188
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
000421
PA
291U00000X
Clinical Medical Laboratory
000983405
PA
291U00000X
Clinical Medical Laboratory
SK301440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000421
MEDICARE BLUE SHIELD
PA
05
—
000983405
—
PA
Enumeration date
12/27/2006
Last updated
02/27/2012
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