Provider Demographics
NPI:1427384304
Name:BURLINGTON LABORATORIES OF SARATOGA COUNTY, LLC
Entity Type:Organization
Organization Name:BURLINGTON LABORATORIES OF SARATOGA COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASARICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-863-4105
Mailing Address - Street 1:12 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12871-1049
Mailing Address - Country:US
Mailing Address - Phone:518-695-3200
Mailing Address - Fax:518-695-3230
Practice Address - Street 1:12 SPRING ST
Practice Address - Street 2:
Practice Address - City:SCHUYLERVILLE
Practice Address - State:NY
Practice Address - Zip Code:12871-1049
Practice Address - Country:US
Practice Address - Phone:518-695-3200
Practice Address - Fax:518-695-3230
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURLINGTON LABORATORIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8451291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory