Organization
PROVIDER LABORATORY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM VURGASON (GENERAL PARTNER)
(207) 333-3278
Entity
Organization
Contact information
Practice address
88 OXFORD ST, LEWISTON, ME 04240-7825
(207) 241-7722
(207) 312-5677
Mailing address
PO BOX 1150, 306 RODMAN ROAD, AUBURN, ME 04211-1150
(207) 333-3278
(207) 333-3037
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/01/2015
Last updated
01/10/2017
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