Organization
INDIAN RIVER MEMORIAL HOSPITAL INC
Active
Other names
Independent Clinical Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L SUSI (CEO)
(772) 567-4311
Entity
Organization
Contact information
Practice address
1000 36TH ST, VERO BEACH, FL 32960-4862
(772) 567-4311
Mailing address
1000 36TH ST, VERO BEACH, FL 32960-4862
(772) 567-4311
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
4029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L9299
BLUE CROSS LAB
FL
Enumeration date
07/03/2008
Last updated
07/03/2008
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