Contract Details
Ancillary Care Services
Facility name
Oracle Diagnostic Laboratory
Provider ID
P000005197
NPI
1720090194
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
100 West Gore Street Suite 302
Orlando, FL 32806
United States
County
Orange
Phone
4074802110 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address