Organization
KING JAMES MEDICAL LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN ANN WENGER (SUPERVISOR)
(440) 835-2150
Entity
Organization
Contact information
Practice address
24700 CENTER RIDGE RD, SUITE 113, WESTLAKE, OH 44145-5636
(440) 835-2150
Mailing address
24700 CENTER RIDGE RD, SUITE 113, WESTLAKE, OH 44145-5636
(440) 835-2150
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D0339322
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36D0339322
CLIA
OH
Enumeration date
01/22/2007
Last updated
07/20/2012
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