Organization
PHOENIX DIAGNOSTIC LABS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAILA J HANOVER (LABORATORY DIRECTOR)
(802) 745-7347
Entity
Organization
Contact information
Practice address
187 SAINT PAUL ST STE 3B-1, BURLINGTON, VT 05401-4689
(802) 745-7347
Mailing address
187 SAINT PAUL ST STE 3B-1, BURLINGTON, VT 05401-4689
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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