Organization
PROST DATA INC
Active
Parent organization
PROST DATA INC
Other names
OUR Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROST DATA INC
Authorized official
DR. JONATHAN OPPENHEIMER (OWNER)
(615) 874-0410
Entity
Organization
Contact information
Practice address
8248 243RD ST, BELLEROSE, NY 11426-1322
(615) 874-0410
Mailing address
PO BOX 291209, NASHVILLE, TN 37229-1209
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33D1085936
CLIA
—
Enumeration date
04/06/2009
Last updated
08/24/2009
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