Organization
MONMOUTH TISSUE LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PORTMAN (OWNER)
(732) 389-1531
Entity
Organization
Contact information
Practice address
10 INDUSTRIAL WAY E, SUITE 110, EATONTOWN, NJ 07724-3332
(732) 460-2838
Mailing address
142 HIGHWAY 35, SUITE 206, EATONTOWN, NJ 07724-1876
(732) 460-2838
(732) 460-2843
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/18/2011
Last updated
07/18/2011
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