Organization
SPECIALTY LABORATORIES, INC.
Active
Parent organization
AMERIPATH INC.
Other names
Mission Pharmacal
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERIPATH INC.
Authorized official
MICHAEL GREENE (VP, MANAGED CARE)
(214) 932-8270
Entity
Organization
Contact information
Practice address
1325 E DURANGO BLVD, SAN ANTONIO, TX 78210-1724
(210) 581-0574
(210) 581-1456
Mailing address
7111 FAIRWAY DR, SUITE 400, PALM BEACH GARDENS, FL 33418-4204
(561) 712-6265
(561) 712-7349
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
TX
332B00000X
Durable Medical Equipment & Medical Supplies
0028276B
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000420325
—
MT
05
—
00738845A
—
GA
05
—
01648843
—
PA
05
—
0511352
—
IA
05
—
0805777
—
MA
05
—
10031209A
—
KS
05
—
1540056
—
LA
05
—
2046360
—
OH
05
—
424507
—
AZ
05
—
7001173
—
NC
05
—
741041775001
—
IL
05
—
98800089
—
CO
05
—
L00085
—
SC
05
—
LOCL81784
—
TX
05
—
XLAB01421
—
CA
Enumeration date
08/24/2005
Last updated
04/01/2008
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