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
20880 West Dixie Highway Suite 101
Miami, FL 33180
United States
County
Miami-Dade
Phone
3058300552 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address