Organization
CAPITAL UROLOGICAL ASSOCIATES LABORATORY
Active
Parent organization
ERIC STOCKALL MD PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ERIC STOCKALL MD PLLC
Authorized official
ERIC STOCKALL (OWNER)
(517) 349-3900
Entity
Organization
Contact information
Practice address
2090 JOLLY RD STE 150, OKEMOS, MI 48864-6036
(517) 349-3900
(517) 349-3939
Mailing address
PO BOX 1070, OKEMOS, MI 48805-1070
(517) 349-3900
(517) 349-3939
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
4301046439
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D0992826
CLIA
MI
Enumeration date
07/06/2011
Last updated
07/06/2011
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