Organization
PREPAID LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD G. HAWES M.D. (MEDICAL DIRECTOR)
(440) 930-7500
Entity
Organization
Contact information
Practice address
33479 LAKE RD, AVON LAKE, OH 44012-1136
(440) 930-7500
(240) 376-6325
Mailing address
PO BOX 171, AVON LAKE, OH 44012-0171
(440) 930-7500
(240) 376-6325
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
35045378
OH
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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