Organization
MNA LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GIANCARLO D.O. (MANAGING MEMBER)
(586) 445-9900
Entity
Organization
Contact information
Practice address
24555 SOUTHFIELD RD, SUITE 190, SOUTHFIELD, MI 48075-2738
(248) 234-8739
Mailing address
34025 HARPER AVE, CLINTON TWP, MI 48035-3737
(586) 445-9900
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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