Organization
SOLI F TAVARIA MC PC
Active
Other names
AMZ Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SOLI F TAVARIA MD (OWNER)
(570) 544-6424
Entity
Organization
Contact information
Practice address
105 N DELAWARE AVE, MINERSVILLE, PA 17954
(570) 544-6424
(570) 544-2734
Mailing address
105 N DELAWARE AVE, MINERSVILLE, PA 17954
(570) 544-6424
(570) 544-2734
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
000877
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007495120001
—
PA
01
—
39D0657443
CLIA CERTIFICATION
PA
Enumeration date
05/23/2007
Last updated
07/03/2008
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