NPI 1285610733

Fort Wayne Medical Laboratory Corporation

Organisation Medical Laboratory Technician Ft Wayne, IN

Practice location

Address: 2470 Lake Ave, Ft Wayne, IN 46805-5406
Phone: (260) 424-2195
Mailing address: 2470 Lake Ave, Fort Wayne, IN 46805-5406

Authorised official

Name: Seung S Kim
Title: Laboratory Director
Phone: (260) 373-3657

Registered specialties

Medical Laboratory Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246RM2200X Licence 50000070A (IN)

Other Technician, Pathology providers in Indiana →

Registry record

NPI: 1285610733
Entity type: Organization
NPI issued: 16 Dec 2005
Record last updated: 1 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.