Organization
IMA INC LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM F HRISOMALOS (DIRECTOR OF LAB)
(812) 355-3406
Entity
Organization
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 331-3406
(812) 334-0536
Mailing address
PO BOX 550, BLOOMINGTON, IN 47402-0550
(812) 331-3406
(812) 334-0536
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
15D0360681
IN
Other
Enumeration date
06/16/2005
Last updated
09/26/2008
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