Contract Details
Ancillary Care Services
Facility name
Nationwide Laboratory Services
Provider ID
P000005552
NPI
1891721536
Tax ID
650648242
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
2030 West McNab Road
Fort Lauderdale, FL 33309
United States
County
Broward
Phone
9546333578 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address