Organization
GREEN CLINICS LABORATORY, LLC
Active
Organization
GREEN CLINICS LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADY JOSEPH GERGES M.D. (OWNER)
(302) 734-5050
Entity
Organization
Contact information
Practice address
1633 SORGHUM MILL RD, DOVER, DE 19901-6810
(302) 734-5050
(302) 734-8080
Mailing address
1633 SORGHUM MILL RD, DOVER, DE 19901-6810
(302) 734-5050
(302) 734-8080
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
C1-0008033
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437211315
—
DE
Enumeration date
09/02/2015
Last updated
01/25/2021
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