Organization
MAIN LINE CLINICAL LABORATORIES
Active
Other names
Main Line Clinical Labs - Paoli Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J BUONGIORNO (CHIEF FINANCIAL OFFICER)
(610) 526-8480
Entity
Organization
Contact information
Practice address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(610) 229-4100
Mailing address
950 E HAVERFORD RD, SUITE 110, BRYN MAWR, PA 19010-3850
(610) 526-8480
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
000199
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015758270004
—
PA
Enumeration date
03/21/2007
Last updated
08/22/2020
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