Organization
PHYSICISNS CLINICAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY A NULL MD (PARTNER)
(570) 454-6301
Entity
Organization
Contact information
Practice address
148 N SHERMAN COURT, HAZLETON, PA 18201-5863
(570) 454-6301
(570) 454-6815
Mailing address
148 N SHERMAN COURT, HAZLETON, PA 18201-5863
(570) 454-6301
(570) 454-6815
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010108250002
—
PA
01
—
398005
BCBS
—
Enumeration date
07/25/2006
Last updated
08/22/2020
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