Organization
REALTOX LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA GOCHNAUER (OWNER)
(410) 833-3025
Entity
Organization
Contact information
Practice address
200 BUSINESS CENTER DR, REISTERSTOWN, MD 21136-1230
(410) 833-3025
(410) 833-3158
Mailing address
200 BUSINESS CENTER DR, REISTERSTOWN, MD 21136-1230
(410) 833-3025
(410) 833-3158
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
21D2077230
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21D2077230
CLIA
MD
Enumeration date
10/13/2014
Last updated
10/13/2014
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