Organization
COMMONWEALTH LABORATORY CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLARD P. MILBY III MD (PRESIDENT)
(804) 330-2154
Entity
Organization
Contact information
Practice address
1401 JOHNSTON WILLIS DR, RICHMOND, VA 23235-4730
(804) 330-2154
Mailing address
PO BOX 5468, MARTINSVILLE, VA 24115-5468
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI3639
RAILROAD MEDICARE
—
Enumeration date
07/26/2005
Last updated
09/28/2018
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