Provider Demographics
NPI:1720436173
Name:NATIONAL MEDICAL LABORATORY, LLC
Entity Type:Organization
Organization Name:NATIONAL MEDICAL LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZAINAB
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMURADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-914-3891
Mailing Address - Street 1:22000 GARRISON ST
Mailing Address - Street 2:SUITE B295
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2306
Mailing Address - Country:US
Mailing Address - Phone:248-914-3891
Mailing Address - Fax:
Practice Address - Street 1:22000 GARRISON ST
Practice Address - Street 2:SUITE B295
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2306
Practice Address - Country:US
Practice Address - Phone:248-914-3891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory