Organization
MIDDLEBURG-LEGACY PLACE, LLC
Active
Other names
Parkside Villa - Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE DASKAL (OWNER)
(440) 260-7626
Entity
Organization
Contact information
Practice address
7040 HEPBURN RD, MIDDLEBURG HEIGHTS, OH 44130-4802
(440) 260-7626
Mailing address
7040 HEPBURN RD, MIDDLEBURG HEIGHTS, OH 44130-4802
(440) 260-7626
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D0991700
OH
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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