Provider Demographics
NPI:1134526536
Name:USA PATHOLOGY AND TOXICOLOGY LABORATORIES, PLLC
Entity type:Organization
Organization Name:USA PATHOLOGY AND TOXICOLOGY LABORATORIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAROOQ
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-719-8691
Mailing Address - Street 1:2945 TURTLE POND CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0720
Mailing Address - Country:US
Mailing Address - Phone:248-719-8691
Mailing Address - Fax:
Practice Address - Street 1:24555 SOUTHFIELD RD
Practice Address - Street 2:SUITE 160
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2738
Practice Address - Country:US
Practice Address - Phone:248-719-8691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory