Organization
ST. ELIZABETH'S DIAGNOSTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ETHAN FALLANG (CEO)
(937) 222-5390
Entity
Organization
Contact information
Practice address
1 ELIZABETH PL, 2ND FLOOR, DAYTON, OH 45417-3445
(937) 222-5390
(937) 222-5331
Mailing address
1 ELIZABETH PL, DAYTON, OH 45417-3445
(937) 222-5390
(937) 222-5331
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
36D1033316
OH
Other
Enumeration date
07/08/2006
Last updated
06/17/2013
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