Provider Demographics
NPI:1679226609
Name:NEUTRON LABORATORY INC
Entity type:Organization
Organization Name:NEUTRON LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIZILBASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-394-2794
Mailing Address - Street 1:100 BIANCA CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-1878
Mailing Address - Country:US
Mailing Address - Phone:570-394-2794
Mailing Address - Fax:
Practice Address - Street 1:100 BIANCA CT
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1878
Practice Address - Country:US
Practice Address - Phone:570-394-2794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty