Organization
MEDFORD MEDICAL LABORATORY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE CHAPPER MT (PRESIDENT)
(781) 395-0518
Entity
Organization
Contact information
Practice address
0 GOVERNORS AVE, B-2, MEDFORD, MA 02155-3025
(781) 395-0518
(781) 391-0040
Mailing address
0 GOVERNORS AVE, B-2, MEDFORD, MA 02155-3025
(781) 395-0518
(781) 391-0040
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2191
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800473
—
MA
Enumeration date
12/17/2005
Last updated
08/22/2020
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