Provider Demographics
NPI:1134528052
Name:COMPLETE LAB & DRUG TEST
Entity type:Organization
Organization Name:COMPLETE LAB & DRUG TEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MLT(ASCP)
Authorized Official - Phone:614-269-7612
Mailing Address - Street 1:PO BOX 247824
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-7824
Mailing Address - Country:US
Mailing Address - Phone:614-596-7808
Mailing Address - Fax:614-319-5050
Practice Address - Street 1:4661 CLEVELAND AVE BLDG A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-5848
Practice Address - Country:US
Practice Address - Phone:614-269-7612
Practice Address - Fax:614-319-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory