Provider Demographics
NPI: | 1326439332 |
---|---|
Name: | CRITERION CHEMISTRIES, LLC |
Entity type: | Organization |
Organization Name: | CRITERION CHEMISTRIES, LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ASHLEY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FORKE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 484-587-9483 |
Mailing Address - Street 1: | 2683 PELHAM PKWY |
Mailing Address - Street 2: | |
Mailing Address - City: | PELHAM |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35124-1354 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 205-358-8851 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2683 PELHAM PKWY |
Practice Address - Street 2: | |
Practice Address - City: | PELHAM |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35124-1354 |
Practice Address - Country: | US |
Practice Address - Phone: | 205-358-7918 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-02-12 |
Last Update Date: | 2024-01-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 291U00000X | Laboratories | Clinical Medical Laboratory |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AL | 22793 | Other | ALABAMA DEPT. OF PUBLIC HEALTH |
AL | 01D2181318 | Other | CLIA |