Provider Demographics
NPI:1235184854
Name:HASSAN NAMDARI
Entity Type:Organization
Organization Name:HASSAN NAMDARI
Other - Org Name:CLIN-MICRO IMMUNOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMDARI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-941-7818
Mailing Address - Street 1:100 ABINGTON EXECUTIVE PARK
Mailing Address - Street 2:SUITE C
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2258
Mailing Address - Country:US
Mailing Address - Phone:570-702-8130
Mailing Address - Fax:570-702-8131
Practice Address - Street 1:100 ABINGTON EXECUTIVE PARK
Practice Address - Street 2:SUITE C
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2258
Practice Address - Country:US
Practice Address - Phone:570-702-8130
Practice Address - Fax:570-702-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA029744291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory