Provider Demographics
NPI:1093593949
Name:OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES LAB, LLC
Entity Type:Organization
Organization Name:OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-462-6144
Mailing Address - Street 1:85 E US HIGHWAY 6 STE 330
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-8948
Mailing Address - Country:US
Mailing Address - Phone:219-462-6144
Mailing Address - Fax:219-286-7902
Practice Address - Street 1:85 E US HIGHWAY 6 STE 330
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8948
Practice Address - Country:US
Practice Address - Phone:219-462-6144
Practice Address - Fax:219-286-7902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory