Provider Demographics
NPI:1942286489
Name:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION INC
Entity Type:Organization
Organization Name:UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION INC
Other - Org Name:CYTOGENTIC LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HERSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-852-7500
Mailing Address - Street 1:571 S FLOYD ST
Mailing Address - Street 2:#100
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3818
Mailing Address - Country:US
Mailing Address - Phone:502-852-7897
Mailing Address - Fax:502-852-2911
Practice Address - Street 1:571 S FLOYD ST
Practice Address - Street 2:#100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3818
Practice Address - Country:US
Practice Address - Phone:502-852-7897
Practice Address - Fax:502-852-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-16
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY18D0648434OtherCLIA
KY37901394Medicaid
KY37901394Medicaid