Provider Demographics
NPI:1629481999
Name:CLINICAL LAB SOLUTIONS
Entity Type:Organization
Organization Name:CLINICAL LAB SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-991-4153
Mailing Address - Street 1:4 NEWPORT DR STE B
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-1647
Mailing Address - Country:US
Mailing Address - Phone:443-991-4153
Mailing Address - Fax:443-519-5167
Practice Address - Street 1:1300 YORK RD
Practice Address - Street 2:C 300
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6016
Practice Address - Country:US
Practice Address - Phone:443-991-4156
Practice Address - Fax:443-519-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory