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General NPI Number Information
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NPI Number | 1144201591
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Entity Type | Organization
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Legal Business Name | NORTH HILL LABORATORY SERVICES LLC
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 825 N 6TH ST
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City | BURLINGTON
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State | IA
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Zip | 52601-4920
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Country | US
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Telephone | 319-752-8422
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Fax | 319-752-4860
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Provider Business Mailing Address
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Address Line | 825 N 6TH ST
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City | BURLINGTON
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State | IA
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Zip | 52601-4920
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Country | US
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Telephone | 319-752-8422
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Fax | 319-752-4860
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROGER ALAN NEVLING
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Credential | PA C
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Telephone | 319-754-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1601011985
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License Number State | IA
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