Provider Demographics
NPI:1427894161
Name:BIOTECH CLINICAL LABORATORIES INC
Entity type:Organization
Organization Name:BIOTECH CLINICAL LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:K
Authorized Official - Last Name:KHALIFEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:124-891-2170
Mailing Address - Street 1:815 WILDT ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2982
Mailing Address - Country:US
Mailing Address - Phone:248-912-1700
Mailing Address - Fax:248-912-1730
Practice Address - Street 1:815 WILDT ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2982
Practice Address - Country:US
Practice Address - Phone:248-912-1700
Practice Address - Fax:248-912-1730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory