Organization
ATLANTIC DIAGNOSTIC LABORATORIES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON DOMENICO (COO)
(267) 525-2470
Entity
Organization
Contact information
Practice address
3520 PROGRESS DR, SUITE C, BENSALEM, PA 19020-5810
(267) 525-2470
(267) 525-2488
Mailing address
3520 PROGRESS DR, SUITE C, BENSALEM, PA 19020-5810
(267) 525-2470
(267) 525-2488
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
024997
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024997
CLINICAL LABORATORY PERMIT
PA
Enumeration date
08/19/2008
Last updated
11/03/2016
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