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DR. ERIC WALTER JOHNSON PH. D.

>> Clinical Medical Laboratory >> Laboratories

Registrant NPI Number: 1598054710

Individual Registrant:
DR. ERIC WALTER JOHNSON PH. D.
Gender: M
Sole Proprietor

Location and contact information for practice:
203 LITCHFIELD ROAD  NORFOLK, CT 06058 US
Tel: 860-689-5814  Fax: --

Contact information for business:
203 LITCHFIELD ROAD P.O. BOX 1 NORFOLK, CT 06058 US
Tel: 860-689-5814  Fax: --

Registration Information:
NPI: 1598054710
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N291U00000XLaboratories
Clinical Medical Laboratory
CT07D0995237
Y291U00000XLaboratories
Clinical Medical Laboratory

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
NEW YORK CQJOHNE2NY01
NEW YORK STATE DOH CERTIFICATE OF QUALIFICATIONJOHNE2NY01




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