1134377781 NPI number — EUROFINS DIATHERIX LABORATORIES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134377781 NPI number — EUROFINS DIATHERIX LABORATORIES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EUROFINS DIATHERIX LABORATORIES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134377781
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 GENOME WAY
Provider Second Line Business Mailing Address:
SUITE 2100
Provider Business Mailing Address City Name:
HUNTSVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35806-2910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-979-4242
Provider Business Mailing Address Fax Number:
256-327-0984

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 GENOME WAY
Provider Second Line Business Practice Location Address:
SUITE 2100
Provider Business Practice Location Address City Name:
HUNTSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35806-2910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-979-4242
Provider Business Practice Location Address Fax Number:
256-327-0984
Provider Enumeration Date:
09/08/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BEVERLY
Authorized Official First Name:
KRISTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTRACT PAYOR SPECIALIST
Authorized Official Telephone Number:
256-755-4292

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  L4557 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 117353400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".