Providence Clinical Lab, LLC
NPI #1346557022 in Somerdale, New Jersey
Provider Information
- NPI Number
- 1346557022
- Entity Type
- Organization
- Organization Name
- Providence Clinical Lab, LLC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Sep 1, 2010
- Last Updated
- Sep 7, 2023
Practice Location
- Address
- 317 AVA AVE
- City
- Somerdale
- State
- New Jersey
- ZIP Code
- 08083-1603
- Phone
- (856) 534-5367
Authorized Official
- Name
- MS. CAROL JOAN EVANS, B.O.R ASCP CERTIFIED
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (856) 534-5367
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
| Clinical Medical Laboratory |
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