Provider Demographics
NPI:1235114067
Name:BAYER REFERENCE TESTING LABORATORY
Entity Type:Organization
Organization Name:BAYER REFERENCE TESTING LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BRTL MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-705-5900
Mailing Address - Street 1:725 POTTER ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2722
Mailing Address - Country:US
Mailing Address - Phone:510-705-5900
Mailing Address - Fax:510-705-5902
Practice Address - Street 1:725 POTTER ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2722
Practice Address - Country:US
Practice Address - Phone:510-705-5900
Practice Address - Fax:510-705-5902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF10781291U00000X
MD733291U00000X
NYPFI4995291U00000X
PA023005291U00000X
RILC000312291U00000X
WVHIV-RL-23291U00000X
CA50355291U00000X
CALEO22797-0291U00000X
CA291U00000X, 291U00000X
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory