Contract Details
Ancillary Care Services
Facility name
Doctors Laboratory
Provider ID
P000004460
NPI
1407850985
Tax ID
562017400
Effective Date
4/1/2012
Last Updated
10/1/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
150 Southeast 17th Street Unit 2
Ocala, FL 34471
United States
County
Marion
Phone
3527327584 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address