Organization
APOLLO DIAGNOSTICS LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM MANSOOR (OWNER)
(248) 615-3100
Entity
Organization
Contact information
Practice address
21999 FARMINGTON RD, SUITE 100, FARMINGTON HILLS, MI 48336-4400
(248) 615-3100
(248) 615-0136
Mailing address
21999 FARMINGTON RD, SUITE 100, FARMINGTON HILLS, MI 48336-4400
(248) 615-3100
(248) 615-0136
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
291U00000X
TAXONOMY
MI
Enumeration date
09/17/2012
Last updated
09/17/2012
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