Provider Demographics
NPI:1770210205
Name:COVID TESTING CENTERS OF AMERICA INC
Entity type:Organization
Organization Name:COVID TESTING CENTERS OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAB DIRECTOR
Authorized Official - Phone:480-670-2000
Mailing Address - Street 1:1193 S EASTWOOD DR STE 1
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-4645
Mailing Address - Country:US
Mailing Address - Phone:847-802-8190
Mailing Address - Fax:
Practice Address - Street 1:1193 S EASTWOOD DR STE 1
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-4645
Practice Address - Country:US
Practice Address - Phone:847-802-8190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory