Provider Demographics
NPI:1669609921
Name:AXIS DIAGNOSTICS, INC.
Entity type:Organization
Organization Name:AXIS DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:OLSHAVSKY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:215-622-3480
Mailing Address - Street 1:825 TOWN CENTER DR STE 148B
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1793
Mailing Address - Country:US
Mailing Address - Phone:267-212-2000
Mailing Address - Fax:267-212-2005
Practice Address - Street 1:825 TOWN CENTER DR STE 148B
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1793
Practice Address - Country:US
Practice Address - Phone:267-212-2000
Practice Address - Fax:267-212-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA31111291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory