Organization
DOMINION PATHOLOGY LABORATORIES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A FRAZIER JR. M.D. (PRESIDENT)
(757) 664-7901
Entity
Organization
Contact information
Practice address
733 BOUSH ST, SUITE 200, NORFOLK, VA 23510-1501
(757) 664-7901
(757) 664-9122
Mailing address
PO BOX 2453, NORFOLK, VA 23501-2453
(757) 664-7901
(757) 664-9122
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004991427
—
VA
01
—
288617
ANTHEM BCBS
VA
Enumeration date
06/02/2006
Last updated
02/11/2011
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