National Provider Identifier Database

SELF EMPLOYED
Physiological Laboratory, (Independent Physiological Lab)

A laboratory that operates independently of a hospital and physician?s office to furnish physiological diagnostic services (e.g. EEG?s , EKG?s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.


Contact Information

SELF-EMPLOYED
95B BARLEY DR
PAINESVILLE, OH44077-5349
Phone: 440-251-9701
Fax:
Website:
Specialty Taxonomy Code
* Physiological Laboratory, (Independent Physiological Lab) 293D00000X

* Indicates primary specialty

NPI Profile & details for SELF-EMPLOYED

NPI Number 1689077125
Legal business name
LBN
SELF-EMPLOYED
Authorized official DELMESHA JACKSON - (STNA)
Entity Organization
Organization subpart No
Enumeration date 09/29/2014
Last updated 09/29/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • OH License #: 47

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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