Organization
HOLLYWOOD DIAGNOSTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE AYALA JIMENEZ (PRESIDENT)
(608) 358-2539
Entity
Organization
Contact information
Practice address
224 W EXCHANGE ST STE 360, AKRON, OH 44302-1715
(608) 358-2539
Mailing address
1907 AMERICAN DR # L1, NEENAH, WI 54956-1236
(608) 358-2539
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
OH
291U00000X
Clinical Medical Laboratory
—
WI
Other
Enumeration date
11/08/2006
Last updated
08/22/2020
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