| Organization Name: | AMERICAN DIAGNSOTIC LAB., INC |
| NPI Number: | 1003963273 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIZABETH C MEDEIROS (MANAGER) |
| Mailing Address: | 144 Main St Brockton |
| State: | MA US |
| Postal Code: | 023014046 |
| Phone Number: | 5089845200 |
| Fax Number: | 5089968614 |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 07/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225400000X |
| License Number: | 34550 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |