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 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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