Organization
IMMUNOGEN DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEEL BOSE (PRESIDENT)
(973) 808-1429
Entity
Organization
Contact information
Practice address
50 FAIRFIELD RD, FAIRFIELD, NJ 07004-2414
(973) 808-5550
(973) 808-5999
Mailing address
50 FAIRFIELD RD, FAIRFIELD, NJ 07004-2414
(973) 808-5550
(973) 808-5999
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31D1107857
CLIA
NJ
Enumeration date
03/26/2010
Last updated
04/14/2010
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