Organization
ADVANTAGE TOXICOLOGY MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MIADICH (MANAGING MEMBER)
(702) 498-5596
Entity
Organization
Contact information
Practice address
297 KINGSBURY GRADE, SUITE 100, MAIL BOX 4470, STATELINE, NV 89449-9804
(702) 598-5596
Mailing address
1801 W OLYMPIC BLVD, FILE 1560, PASADENA, CA 91199-1560
(702) 498-5596
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
06/08/2012
Last updated
01/13/2015
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