Organization
MEDICON DIAGNOSTIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAWAN SALEH (LAB MANAGER)
(973) 832-3405
Entity
Organization
Contact information
Practice address
1040 MAIN ST, PATERSON, NJ 07503-2212
(973) 832-3405
Mailing address
1040 MAIN ST, PATERSON, NJ 07503-2212
(973) 832-3405
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19317
CLIS
NJ
Enumeration date
04/26/2022
Last updated
05/26/2022
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