Organization
OLD DOMINION UNIVERSITY
Active
Parent organization
OLD DOMINION UNIVERSITY
Other names
Monarch Molecular Clinical Laboratory
Organization subpart
Yes
Provider details
NPI number
Legal business name
OLD DOMINION UNIVERSITY
Authorized official
DR. PETER ANTHONY MOLLICA PHD (LABORATORY DIRECTOR)
(757) 683-3459
Entity
Organization
Contact information
Practice address
4111 MONARCH WAY, ROOM 3104, NORFOLK, VA 23508
(757) 683-5393
Mailing address
4608 HAMPTON BLVD, 2118 HEALTH SCIENCES BLDG, NORFOLK, VA 23508
(757) 683-3247
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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