Fort Wayne Medical Laboratory Corporation

NPI #1285610733 in Ft Wayne, Indiana

Provider Information

NPI Number
1285610733
Entity Type
Organization
Organization Name
Fort Wayne Medical Laboratory Corporation
Primary Specialty
Technician, Pathology - Medical Laboratory
Enumeration Date
Dec 16, 2005
Last Updated
Mar 1, 2012

Practice Location

Address
2470 LAKE AVE
State
Indiana
ZIP Code
46805-5406
Phone
(260) 424-2195

Authorized Official

Name
SEUNG S KIM, MD., PHD
Title
LABORATORY DIRECTOR
Phone
(260) 373-3657

Specialties & Taxonomy Codes

Specialty
Technician, Pathology - Medical LaboratoryMedical Laboratory

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