Provider Demographics
NPI:1023269313
Name:FORENSIC FLUIDS LABORATORIES INC.
Entity type:Organization
Organization Name:FORENSIC FLUIDS LABORATORIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-492-7700
Mailing Address - Street 1:225 PARSONS ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3597
Mailing Address - Country:US
Mailing Address - Phone:269-492-7700
Mailing Address - Fax:269-492-7704
Practice Address - Street 1:225 PARSONS ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3597
Practice Address - Country:US
Practice Address - Phone:269-492-7700
Practice Address - Fax:269-492-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-04
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23D1045429291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory