Organization
MERITUS MEDICAL LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA REPAC (CFO)
(301) 790-9351
Entity
Organization
Contact information
Practice address
11110 MEDICAL CAMPUS RD, SUITE 230, HAGERSTOWN, MD 21742-6700
(301) 665-4900
(301) 665-4949
Mailing address
11110 MEDICAL CAMPUS RD, SUITE 230, HAGERSTOWN, MD 21742-6700
(301) 665-4900
(301) 665-4949
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
134
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214847
MDIPA/MAMSI/UHC
—
05
—
411588104
—
MD
05
—
5580431
—
WV
Enumeration date
06/19/2006
Last updated
10/26/2022
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