Organization
SUBURBAN MEDICAL LABORATORY, INC.
Active
Other names
Medlab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD ELMER HOSKINS (DIRECTOR, BILLING OPERATIONS)
(513) 752-7300
Entity
Organization
Contact information
Practice address
39303 COUNTRY CLUB DR, SUITE C-30, FARMINGTON HILLS, MI 48331-3478
(513) 752-7300
(513) 201-0013
Mailing address
665 OHIO PIKE, CINCINNATI, OH 45245-2117
(513) 752-7300
(513) 201-0013
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D0339673
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0288004
—
OH
01
—
36D0339673
CLIA
OH
Enumeration date
07/24/2012
Last updated
08/21/2012
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