Provider Demographics
NPI:1396137162
Name:ALERE TOXICOLOGY, INC.
Entity type:Organization
Organization Name:ALERE TOXICOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1866-928-9877
Mailing Address - Street 1:14440 MYERLAKE CIR STE B
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-2813
Mailing Address - Country:US
Mailing Address - Phone:186-692-8987
Mailing Address - Fax:
Practice Address - Street 1:14440 MYERLAKE CIR STE B
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-2813
Practice Address - Country:US
Practice Address - Phone:186-692-8987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALERE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-03
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X
FL800027595291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory