Provider Demographics
NPI:1629209853
Name:HEALTH DIAGNOSTIC LABORATORY, INCORPORATED
Entity Type:Organization
Organization Name:HEALTH DIAGNOSTIC LABORATORY, INCORPORATED
Other - Org Name:HDL, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-343-2718
Mailing Address - Street 1:737 N 5TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-1441
Mailing Address - Country:US
Mailing Address - Phone:804-343-2718
Mailing Address - Fax:804-343-2704
Practice Address - Street 1:737 N 5TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1441
Practice Address - Country:US
Practice Address - Phone:804-343-2718
Practice Address - Fax:804-343-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA49D1100708291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory