Organization
ATHENS MEDICAL TESTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS MUNTEAN (MEMBER/ADMINISTRATOR)
(410) 262-3853
Entity
Organization
Contact information
Practice address
26 E PARK DR STE 105, ATHENS, OH 45701-5003
(740) 249-4075
Mailing address
26 E PARK DR STE 105, ATHENS, OH 45701-5003
(740) 249-4075
(740) 249-4466
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D2050500
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024116
COLA
—
01
—
36D2050500
CLIA
OH
Enumeration date
12/11/2012
Last updated
10/17/2018
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