Organization
DERMATOPATHOLOGY LABORATORY OF CENTRAL STATES - MICHIGAN
Active
Parent organization
DERMATOPATHOLOGY LABORATORY OF CENTRAL STATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERMATOPATHOLOGY LABORATORY OF CENTRAL STATES
Authorized official
JOHN J. MACKE (CHIEF EXECUTIVE OFFICER)
(937) 312-3826
Entity
Organization
Contact information
Practice address
1100 OWENDALE DR, SUITE A, TROY, MI 48083-1914
(800) 592-5192
(248) 519-1047
Mailing address
7835 PARAGON RD, DAYTON, OH 45459-4021
(800) 532-3232
(800) 840-0819
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
03/14/2015
Last updated
03/14/2015
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