Provider Demographics
NPI:1609524321
Name:OXFORD CLINICAL SOLUTION LLC
Entity Type:Organization
Organization Name:OXFORD CLINICAL SOLUTION LLC
Other - Org Name:PROGRESSIVE TESTING LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-398-8729
Mailing Address - Street 1:1547B FINNEGAN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1547B FINNEGAN LN
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1061
Practice Address - Country:US
Practice Address - Phone:561-398-8729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory