Organization
TERRE HAUTE MEDICAL LABORATORY, INC.
Active
Parent organization
TERRE HAUTE MEDICAL LABORATORY, INC.
Other names
MEDLAB
Organization subpart
Yes
Provider details
NPI number
Legal business name
TERRE HAUTE MEDICAL LABORATORY, INC.
Authorized official
DR. WILLIAM DAVID DEPOND M.D. (PRESIDENT/CHIEF MEDICAL OFFICER)
(812) 244-0100
Entity
Organization
Contact information
Practice address
890 RIDGELAWN RD, SUITE A, MARTINSVILLE, IL 62442
(812) 244-0100
(812) 244-0096
Mailing address
634 BEECH ST, TERRE HAUTE, IN 47804-2760
(812) 244-0100
(812) 244-0096
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
50000920A
IN
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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