Provider Demographics
NPI:1851536460
Name:CLEVELAND CLINIC MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:CLEVELAND CLINIC MEDICAL SERVICES, INC.
Other - Org Name:ALLOGEN LABORATORIES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEDHAT
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ASKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:216-444-5918
Mailing Address - Street 1:10524 EUCLID AVE
Mailing Address - Street 2:MAIL CODE C100
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2205
Mailing Address - Country:US
Mailing Address - Phone:216-445-1561
Mailing Address - Fax:216-444-8261
Practice Address - Street 1:415 MORRIS ST
Practice Address - Street 2:SUITE 403
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1842
Practice Address - Country:US
Practice Address - Phone:304-388-7929
Practice Address - Fax:304-388-7939
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLEVELAND CLINIC FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV51D0991289291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory