Organization
SUBURBAN MEDICAL LABORATORY, INC
Active
Organization
SUBURBAN MEDICAL LABORATORY, INC
Active
Other names
MEDLAB
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD HOSKINS (DIRECTOR, BILLING)
51237527300
Entity
Organization
Contact information
Practice address
6800 VIRGINIA MANOR RD, BELTSVILLE, MD 20705-4200
(216) 409-7394
Mailing address
6800 VIRGINIA MANOR RD, BELTSVILLE, MD 20705-4200
(216) 409-7394
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D0339673
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
WORKERS COMP
OH
05
—
0288004
—
OH
01
—
36D0339673
CLIA
OH
Enumeration date
09/29/2011
Last updated
02/21/2012
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