Healthcare Provider Details
I. General information
NPI: 1891758314
Provider Name (Legal Business Name): LABORATORY MEDICINE SPECIALISTS OF DULUTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2006
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1346 W ARROWHEAD RD
DULUTH MN
55811-2218
US
IV. Provider business mailing address
915 E 1ST ST
DULUTH MN
55805-2107
US
V. Phone/Fax
- Phone: 800-288-8325
- Fax: 218-726-3007
- Phone: 218-249-5208
- Fax: 218-726-3007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | 854 |
| License Number State | MN |
VIII. Authorized Official
Name:
SARAH
LUNDEEN
Title or Position: TREASURER
Credential: MD
Phone: 800-288-8325