Organization
NORDX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D MCAVOY (CFO)
(207) 396-7812
Entity
Organization
Contact information
Practice address
301A US ROUTE 1, FINANCE DEPT RE: HLA LAB, SCARBOROUGH, ME 04074-9701
(207) 396-7812
(207) 396-7880
Mailing address
301A US ROUTE 1, FINANCE DEPT RE: HLA LAB, SCARBOROUGH, ME 04074-9701
(207) 396-7812
(207) 396-7880
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
20D0911771
ME
291U00000X
Clinical Medical Laboratory
Primary
MEDLC 001
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-HL02
HISTOCOMPATABILITY LAB
ME
Enumeration date
02/10/2009
Last updated
12/13/2011
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