Organization
DOMINION DIAGNOSTICS, LLC
Active
Organization
DOMINION DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JORDAN (CHIEF OPERATING OFFICER)
(877) 734-9600
Entity
Organization
Contact information
Practice address
484 HIGHLAND AVE, FALL RIVER, MA 02720-3704
(877) 734-9600
Mailing address
211 CIRCUIT DR, NORTH KINGSTOWN, RI 02852-7440
(877) 734-9600
(401) 667-0330
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LCI 00343
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805939
—
MA
Enumeration date
07/01/2009
Last updated
07/01/2009
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