Organization
MEDICAL LABORATORY OF OLEAN
Active
Other names
MLO Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
BABU A BHAWSAR MA (PRESIDENT)
(716) 373-2670
Entity
Organization
Contact information
Practice address
2626 W STATE ST, OLEAN, NY 14760-1858
(716) 373-2670
(716) 373-2673
Mailing address
2626 W STATE ST, OLEAN, NY 14760-1858
(716) 373-2670
(716) 373-2673
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
PFI3746
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014835380001
—
PA
05
—
01200908
—
NY
01
—
PFI3746
STATE LICENSE NUMBER
NY
Enumeration date
08/25/2005
Last updated
08/22/2020
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