Organization
NORTH CAUSEWAY MEDICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A. KUCKER D.O. (LAB DIRECTOR)
(386) 957-3815
Entity
Organization
Contact information
Practice address
161 N CAUSEWAY, SUITE D, NEW SMYRNA BEACH, FL 32169-5303
(386) 957-3815
(386) 428-6696
Mailing address
161 N CAUSEWAY, SUITE D, NEW SMYRNA BEACH, FL 32169-5303
(386) 957-3815
(386) 428-6696
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800026144
FL
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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