Provider Demographics
NPI:1285827121
Name:CHOICE DIAGNOSTICS
Entity Type:Organization
Organization Name:CHOICE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANILE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-557-7537
Mailing Address - Street 1:1101 DECATUR ST
Mailing Address - Street 2:1ST FLOOR LABORATORY
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3335
Mailing Address - Country:US
Mailing Address - Phone:419-557-7537
Mailing Address - Fax:
Practice Address - Street 1:1101 DECATUR ST
Practice Address - Street 2:1ST FLOOR LABORATORY
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3335
Practice Address - Country:US
Practice Address - Phone:419-557-7537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory