Organization
LAUREL PATHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN L MCCLINTOCK (BILLING ADMINISTRATOR)
(814) 444-8910
Entity
Organization
Contact information
Practice address
500 W BERKELEY ST, UNIONTOWN, PA 15401-5514
(724) 430-5159
(724) 430-3835
Mailing address
PO BOX 1198, SOMERSET, PA 15501-0336
(814) 444-8910
(814) 444-9782
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018644720003
—
PA
01
—
1313083
BLUE SHIELD
PA
05
—
1520282
—
PA
01
—
2024671000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
07/03/2006
Last updated
06/30/2008
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