Provider Demographics
NPI:1194005355
Name:METABOLON, INC.
Entity Type:Organization
Organization Name:METABOLON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-595-2208
Mailing Address - Street 1:PO BOX 110407
Mailing Address - Street 2:
Mailing Address - City:RESEARCH TRIANGLE PARK
Mailing Address - State:NC
Mailing Address - Zip Code:27709-5407
Mailing Address - Country:US
Mailing Address - Phone:919-595-2208
Mailing Address - Fax:919-287-2962
Practice Address - Street 1:617 DAVIS DR
Practice Address - Street 2:STE 400
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-572-1711
Practice Address - Fax:919-287-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory