Organization
EVERGREEN DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A FAULKNER (DIRECTOR)
(517) 371-1111
Entity
Organization
Contact information
Practice address
2025 S WASHINGTON AVE, SUITE 210, LANSING, MI 48910-0828
(517) 371-1111
(517) 371-1121
Mailing address
2025 S WASHINGTON AVE, SUITE 210, LANSING, MI 48910-0828
(517) 371-1111
(517) 371-1121
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D1101213
MI
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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