Organization
COMPUNET CLINICAL LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M MANIER (CFO)
(937) 297-8202
Entity
Organization
Contact information
Practice address
3535 PENTAGON BLVD STE 400, BEAVERCREEK, OH 45431-1705
(937) 296-0844
(937) 297-8254
Mailing address
2308 SANDRIDGE DR, ATTENTION: CINDY ALEXANDER, MORAINE, OH 45439-1847
(937) 297-8253
(937) 297-8254
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36D2066338
CLIA
OH
Enumeration date
11/20/2013
Last updated
11/20/2013
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