Organization
THERAMEDICAL LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MALUCHNIK (CFO)
(419) 509-1635
Entity
Organization
Contact information
Practice address
24555 SOUTHFIELD RD, SUITE 120, SOUTHFIELD, MI 48075-2738
(419) 509-1635
(877) 765-5868
Mailing address
PO BOX 12, PERRYSBURG, OH 43552-0012
(419) 509-1635
(877) 765-5868
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/16/2014
Last updated
10/16/2014
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