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Organization

GREAT LAKE LABORATORIES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WAQAR MIAN (MEDICAL DIRECTOR)
(989) 780-4415
Entity
Organization

Contact information

Practice address
1525 W CARO RD, CARO, MI 48723-9686
(989) 670-6000
Mailing address
PO BOX 513, CARO, MI 48723-0513
(989) 670-6000

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
09/27/2014
Last updated
01/02/2015
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