Provider Demographics
NPI:1104229541
Name:TOTAL TOXICOLOGY LABS LLC
Entity type:Organization
Organization Name:TOTAL TOXICOLOGY LABS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:248-352-7171
Mailing Address - Street 1:24525 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2740
Mailing Address - Country:US
Mailing Address - Phone:248-352-7171
Mailing Address - Fax:248-352-7273
Practice Address - Street 1:24525 SOUTHFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2740
Practice Address - Country:US
Practice Address - Phone:248-352-7171
Practice Address - Fax:248-352-7273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory