Organization
FST LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRITZ MAIGNAN LPC (OWNER)
(203) 870-6050
Entity
Organization
Contact information
Practice address
48 ALPINE ST, BRIDGEPORT, CT 06610-1727
(203) 870-6050
(203) 333-9098
Mailing address
48 ALPINE ST, BRIDGEPORT, CT 06610-1727
(203) 870-6050
(203) 333-9098
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
07D2023800
CT
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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