Provider Demographics
NPI:1619980430
Name:UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION
Entity Type:Organization
Organization Name:UNIVERSITY HOSPITALS LABORATORY SERVICES FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, FP&A
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-767-8141
Mailing Address - Street 1:PO BOX 772930
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2930
Mailing Address - Country:US
Mailing Address - Phone:216-844-5227
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:PATH 5077
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0195926Medicaid
OHD369511Medicare PIN
OHD368944Medicare PIN
OHD368931Medicare PIN
OHD368471Medicare PIN
OHD369341Medicare PIN
OHD368942Medicare PIN
OH0195926Medicaid
OHD368943Medicare PIN