Provider Demographics
NPI:1710529086
Name:CAPITAL PATHOLOGY LABORATORIES, INC.
Entity Type:Organization
Organization Name:CAPITAL PATHOLOGY LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-942-6377
Mailing Address - Street 1:1980 GALLOWS RD # 3022
Mailing Address - Street 2:
Mailing Address - City:TYSONS
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1980 GALLOWS RD # 3022
Practice Address - Street 2:
Practice Address - City:TYSONS
Practice Address - State:VA
Practice Address - Zip Code:22182-3913
Practice Address - Country:US
Practice Address - Phone:703-942-6377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty