Organization
NORTH COAST CLINICAL LABORATORY, INC.
Active
Organization
NORTH COAST CLINICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK C. RUNNER MBA, MT(ASCP), SM(AA (ADMINISTRATIVE DIRECTOR)
(419) 626-6012
Entity
Organization
Contact information
Practice address
2215 CLEVELAND RD, SUITE 105, SANDUSKY, OH 44870-4485
(419) 626-6012
(419) 626-0814
Mailing address
2215 CLEVELAND RD, SUITE 105, SANDUSKY, OH 44870-4485
(419) 626-6012
(419) 626-0814
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0634273
—
OH
05
—
36D0344271
—
MI
Enumeration date
11/11/2005
Last updated
11/24/2014
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