Provider Demographics
NPI:1053138982
Name:HISTOLOGY LAB PARTNERS, LLC
Entity type:Organization
Organization Name:HISTOLOGY LAB PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-252-8968
Mailing Address - Street 1:1701 SOUTH BLVD E STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6120
Mailing Address - Country:US
Mailing Address - Phone:248-884-9710
Mailing Address - Fax:248-884-9711
Practice Address - Street 1:4600 INVESTMENT DR STE 360
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6368
Practice Address - Country:US
Practice Address - Phone:248-884-9710
Practice Address - Fax:248-312-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty