Provider First Line Business Practice Location Address: 
720 BLACKBURN RD
    Provider Second Line Business Practice Location Address: 
DEPARTMENT OF PATHOLOGY
    Provider Business Practice Location Address City Name: 
SEWICKLEY
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
15143-1459
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
412-749-7364
    Provider Business Practice Location Address Fax Number: 
412-741-4745
    Provider Enumeration Date: 
07/31/2006