Organization
PRISM MOLECULAR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD M WEGMAN (PRESIDENT)
(314) 952-2370
Entity
Organization
Contact information
Practice address
1801 MAIN ST STE 104, BLAKELY, PA 18447-1365
(570) 382-8125
Mailing address
140 ENCHANTED PKWY STE 202, MANCHESTER, MO 63021-5491
(314) 952-3261
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
04/01/2024
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