Nature Coast Primary Care Lab LLC
NPI #1114534385 in Crystal River, Florida
Provider Information
- NPI Number
- 1114534385
- Entity Type
- Organization
- Organization Name
- Nature Coast Primary Care Lab LLC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Sep 30, 2020
- Last Updated
- Nov 5, 2020
Practice Location
- Address
- 7562 W GULF TO LAKE HWY
- City
- Crystal River
- State
- Florida
- ZIP Code
- 34429-7840
- Phone
- (352) 436-4328
Authorized Official
- Name
- MR. EDWARD R KOP
- Title
- DELEGATED OFFICIAL
- Phone
- (352) 362-0627
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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