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Organization

CAPITAL UROLOGICAL ASSOCIATES LABORATORY

Active
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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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