Provider Demographics
NPI:1265146385
Name:UNIVERSITY CLINICAL SERVICES LLC
Entity type:Organization
Organization Name:UNIVERSITY CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-770-9074
Mailing Address - Street 1:1075 MORRIS AVE STE 323324
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7137
Mailing Address - Country:US
Mailing Address - Phone:908-737-7238
Mailing Address - Fax:
Practice Address - Street 1:1075 MORRIS AVE STE 323324
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7137
Practice Address - Country:US
Practice Address - Phone:908-737-7238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory