Organization
OTTENDORF LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KONRAD H KAEDING (SOLE OWNER AND MANAGER)
(302) 593-5904
Entity
Organization
Contact information
Practice address
1095 INVESTMENT BLVD, APEX, NC 27502-1799
(919) 390-3566
(919) 629-8402
Mailing address
3922 GISBOURNE DR, JAMESTOWN, NC 27282-7706
(302) 518-3022
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437533254
—
NC
Enumeration date
07/10/2015
Last updated
04/05/2021
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