Organization
LABORATORY RX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AURA IONITA (PRACTICE ADMINISTRATOR)
(703) 522-2727
Entity
Organization
Contact information
Practice address
92 THOMAS JOHNSON DR STE 205, FREDERICK, MD 21702-4403
(240) 815-5449
Mailing address
217 E CHURCHVILLE RD, BEL AIR, MD 21014-3825
(410) 698-2665
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
MD
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21D2138383
CLIA
MD
01
—
2726
LAB CERTIFICATION
MD
Enumeration date
08/31/2012
Last updated
07/29/2022
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