Organization
INDEPENDENT LAB SERVICES
Active
Organization
INDEPENDENT LAB SERVICES
Active
Parent organization
ADO HEALTH SERVICES INC.
Other names
Independent Lab Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADO HEALTH SERVICES INC.
Authorized official
NICOLE KENDRA-TOWNSEND CCS (CREDENTIALING SPECIALIST)
(330) 629-2888
Entity
Organization
Contact information
Practice address
590 E WESTERN RESERVE RD, BUILDING 5, YOUNGSTOWN, OH 44514-3354
(330) 403-8034
(330) 629-2966
Mailing address
1027 BOARDMAN CANFIELD RD, YOUNGSTOWN, OH 44512-4227
(330) 629-2888
(330) 629-2946
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D2068849
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115372
—
OH
05
—
201353260 A
—
IN
01
—
26184
COLA
OH
01
—
36D2110782
CLIA
OH
Enumeration date
09/22/2014
Last updated
01/27/2017
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