Organization
LABORATORY ACQUISITION COMPANY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE BLEVINS (OFFICE MANAGER)
(334) 263-6228
Entity
Organization
Contact information
Practice address
225B WINTON M BLOUNT LOOP, MONTGOMERY, AL 36117-3507
(334) 263-6228
(334) 265-9136
Mailing address
225B WINTON M BLOUNT LOOP, MONTGOMERY, AL 36117-3507
(334) 263-6228
(334) 265-9136
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
9178
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051543495
BCBS
AL
05
—
100662
—
AL
05
—
100663
—
AL
Enumeration date
07/18/2007
Last updated
09/07/2012
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