Organization
HEARTLAND LABORATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F BLANK M.D. (PATHOLOGIST)
57388736321
Entity
Organization
Contact information
Practice address
221 S MAIN ST, CHAFFEE, MO 63740-1040
(573) 887-3632
(573) 887-3635
Mailing address
221 S MAIN ST, CHAFFEE, MO 63740-1040
(573) 887-3632
(573) 887-3635
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
34699
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036081467
PATHOLOGY
IL
01
—
207ZD0900X MO
PATHOLOGY
MO
Enumeration date
08/06/2007
Last updated
03/22/2010
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