Organization
TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
Active
Other names
UPPL-UNIV OF PENN PATHOLOGY LABS
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(800) 736-6522
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265914000
KEYSTONE
PA
05
—
1001258770065
—
PA
01
—
10377
HEALTHPARTNERS
PA
01
—
133759
BLUE SHIELD
PA
Enumeration date
05/16/2007
Last updated
02/07/2008
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