Organization
CLINICAL LABORATORY GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN DAVID LOTOW (OWNER)
(352) 514-7920
Entity
Organization
Contact information
Practice address
298 S LAWRENCE BLVD, KEYSTONE HEIGHTS, FL 32656-9217
(352) 473-8483
Mailing address
19804 NE 22ND LN, HAWTHORNE, FL 32640-2900
(352) 514-7920
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D200128
FL
Other
Enumeration date
03/07/2010
Last updated
03/07/2010
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