| Doctor Name: | MRS. LISA MARIE RANDALL |
| NPI Number: | 1285992164 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CERT.TECH |
| License Number: | |
| Business Practice Address: | 970 County Route 56 Potsdam, NY - 136763351 |
| Business Phone Number: | 3152127817 |
| Business Fax Number: | |
| Mailing Address: | 970 County Route 56, POTSDAM |
| State: | NY |
| Postal Code: | 13676 |
| Phone Number: | 3152127817 |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2012 |
| NPI Last Update Date: | 11/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246RP1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Technician, Pathology |
| Taxonomy Specialization: | Phlebotomy |
| Taxonomy Definition: | |