Contract Details
DCL Medical Laboratories, LLC
Facility name
Dcl Medical Laboratories, LLC
Provider ID
P000006040
Tax ID
260844836
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
2100 Madison Ave
Granite City, IL 62040
United States
County
Madison
Phone
6187983000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address