Organization
LAB AT SEASCAPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD ALLEN WILSON III (PRESIDENT)
(760) 807-7983
Entity
Organization
Contact information
Practice address
200 W LIBERTY WAY STE B, MILFORD, DE 19963-5463
(302) 491-4258
(973) 954-4022
Mailing address
1031 CANTERBURY RD, MILFORD, DE 19963-5511
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018609192
DE BUSINESS LICENSE
DE
Enumeration date
12/04/2018
Last updated
11/15/2024
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