Organization
MACROLAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE SEDRAKYAN MD (MEDICAL DIRECTOR)
(267) 978-1993
Entity
Organization
Contact information
Practice address
1310 INDUSTRIAL HWY, SUITE 203, SOUTHAMPTON, PA 18966-4030
(267) 978-1993
Mailing address
1310 INDUSTRIAL HWY, SUITE 203, SOUTHAMPTON, PA 18966-4030
(267) 978-1993
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
39D2016029
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39D2016029
CLIA
—
Enumeration date
11/26/2010
Last updated
11/26/2010
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