MICRO PATH LABORATORIES INC
Medical Laboratory at Bartow Rd, Lakeland, FL

License number
Florida 800000683
Category
Medical Laboratory
Type
Clinical Medical Laboratory
Owner
Name: DR. CRAIG D LARISCY M.D.
Title: PRESIDENT
Phone: (863) 683-7171
Address
Address
1125 Bartow Rd SUITE 101, Lakeland, FL 33801
National Provider ID: 1932159118
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MICRO PATH LABORATORIES, INC

Lakeland, FL

Status:
Inactive
Industry:
Pathology Laboratory
Doing business as:
Micro Path Laboratory<br>District 10 Med Examiners Off<br>Micro Path Laboratories
Inactive reason:
AMENDMENT
Registration:
Dec 24, 1991
Inactive since:
Jun 22, 2004
Phone:
(863) 683-7171 (Phone)
Addresses:
1125 Bartow Rd STE 101, Lakeland, FL 33801 (Physical)
1635 Lakeland Hl Blvd, Lakeland, FL 33805
State ID:
V02889
Business type:
Florida Profit Corporation
Executive Directors:
Craig D Lariscy (Vice President, President), 1125 Bartow Rd, Lakeland, FL 33801 (Physical),Evander A Boynton (Treasurer, Dermatology), 1125 Bartow Rd, Lakeland, FL 33801 (Physical),Brian J Yoder (Vice President, Osteopathy), 1125 Bartow Rd, Lakeland, FL 33801 (Physical),...
Agent:
Craig Lariscy,1125 Bartow Rd, Lakeland, FL 33801 (Physical)
EIN:
593097649

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