Provider Demographics
NPI:1235520313
Name:PATINO LABORATORIES LLC
Entity Type:Organization
Organization Name:PATINO LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-207-9999
Mailing Address - Street 1:29150 BUCKINGHAM
Mailing Address - Street 2:SUITE 12
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-7500
Mailing Address - Country:US
Mailing Address - Phone:734-207-9999
Mailing Address - Fax:734-943-6009
Practice Address - Street 1:29150 BUCKINGHAM
Practice Address - Street 2:SUITE 12
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-7500
Practice Address - Country:US
Practice Address - Phone:734-207-9999
Practice Address - Fax:734-943-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory