NPI 1669522199

J L Costin, MD, PC

Organisation Clinical Medical Laboratory Poplar Bluff, MO

Practice location

Address: 3069 N Westwood Blvd STE a, Poplar Bluff, MO 63901
Phone: (573) 785-8405
Fax: (573) 778-0425
Mailing address: PO Box 4057, Poplar Bluff, MO 63902-4057

Authorised official

Name: Sue E Costin
Title: Director of Operations
Phone: (573) 785-8405

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X

Other Clinical Medical Laboratory providers in Missouri →

Registry record

NPI: 1669522199
Entity type: Organization
NPI issued: 10 Jan 2007
Record last updated: 28 Nov 2007

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.