Organization
COMMONWEALTH MEDICAL LABS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D PRATT (PRESIDENT)
(540) 428-2909
Entity
Organization
Contact information
Practice address
4228 AIKEN DR, WARRENTON, VA 20187-3931
(540) 428-2909
(540) 428-2905
Mailing address
4228 AIKEN DR, WARRENTON, VA 20187-3931
(540) 428-2909
(540) 428-2905
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
49D0661031
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000420359
—
MT
05
—
00366099A
—
GA
05
—
004980832
—
VA
05
—
009801680
—
AL
05
—
0122009
—
MS
05
—
0517383
—
IA
05
—
0724056-02
—
TX
05
—
0899167
—
OH
05
—
100027530A
—
IN
05
—
114211709
—
AR
05
—
1537527
—
LA
01
—
35460
SOUTHERN HEALTH SVCS
VA
05
—
37901907
—
KY
01
—
465710
ANTHEM BLUE CROSS BLUE SH
VA
01
—
690008904
RAILROAD MEDICARE
—
05
—
7001088
—
NC
05
—
706118908
—
MO
05
—
805782200
—
ID
01
—
923-19860
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/02/2006
Last updated
12/14/2009
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