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Organization

MADISON CORE LABORATORIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GUY E JONES (CREDENTIALING)
(256) 850-0075
Entity
Organization

Contact information

Practice address
2705 ARTIE ST SW, BLDG 400 SUITE 25, HUNTSVILLE, AL 35805
(256) 850-0075
(256) 850-3186
Mailing address
PO BOX 1565, HUNTSVILLE, AL 35807-0565
(256) 850-0075
(256) 850-3186

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01D2097667
CLIA
AL
01
01D2116823
CLIA
AL
01
1174912695
NPI
01
L45100
DEPT. OF PUBLIC HEALTH
AL
01
L4593
DEPT. OF PUBLIC HEALTH
AL
Enumeration date
01/21/2015
Last updated
11/01/2022
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