Organization
MEDI LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY GILLEN (BILLING)
(419) 228-8800
Entity
Organization
Contact information
Practice address
855 W MARKET ST, LIMA, OH 45805-2795
(419) 228-8800
Mailing address
855 W MARKET ST, LIMA, OH 45805-2795
(419) 228-8800
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0325277
—
OH
Enumeration date
10/03/2005
Last updated
10/15/2007
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