Organization
PATHOLOGY SERVICES.ORG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA WORLEY CT,ASCP,IAC (LIMITED MEMBER/SOLE OWNER)
(231) 590-5030
Entity
Organization
Contact information
Practice address
1465 E PARKDALE AVE, CYTOPATHOLOGY/INDEPENDENT LABORATORY, MANISTEE, MI 49660-0070
(231) 590-5030
(231) 889-5969
Mailing address
PO BOX 70, ATT'N LISA WORLEY, MANISTEE, MI 49660-0070
(231) 590-5030
Taxonomy
Speciality
Code
Description
License number
State
246R00000X
Pathology Technician
—
—
291U00000X
Clinical Medical Laboratory
Primary
23D0981736
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E11500
BLUE CROSS BLUE SHIELDPPO
MI
05
—
4280673
—
MI
01
—
71020000E11500
BCBS OF MICHIGAN
MI
Enumeration date
08/21/2006
Last updated
04/28/2010
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