Provider Demographics
NPI:1215572870
Name:ALBEMARLE LABORATORIES
Entity Type:Organization
Organization Name:ALBEMARLE LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-948-1051
Mailing Address - Street 1:PO BOX 8998
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222-0998
Mailing Address - Country:US
Mailing Address - Phone:410-948-1051
Mailing Address - Fax:
Practice Address - Street 1:40 S DUNDALK AVE STE 302
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4232
Practice Address - Country:US
Practice Address - Phone:410-948-1051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD656004100Medicaid
MD21D2173396OtherCLIA
MD2995OtherSTATE LAB PERMIT