Organization
FAULKNER MEDICAL LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DISOUNGH TIMMONS (MANAGER)
(781) 322-8502
Entity
Organization
Contact information
Practice address
410 FERRY ST, MALDEN, MA 02148-7809
(781) 322-8502
(781) 322-8032
Mailing address
410 FERRY ST, MALDEN, MA 02148-7809
(781) 322-8502
(781) 322-8032
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2432
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000021296
BMC HEALTH NET
MA
05
—
0800368
—
MA
01
—
228021
BLUE CROSS & BLUE SHIELD
MA
01
—
801323
SECURE HORIZONS
MA
Enumeration date
07/14/2006
Last updated
08/22/2020
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