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General NPI Number Information
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NPI Number | 1164710893
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Entity Type | Organization
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Legal Business Name | LABTRAN CLINICAL LABORATORIES, LLC
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 2404 E MILL PLAIN BLVD STE B
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City | VANCOUVER
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State | WA
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Zip | 98661-4334
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Country | US
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Telephone | 855-522-8726
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Fax | 888-581-0336
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Provider Business Mailing Address
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Address Line | 106 WESTHILL DRIVE, UNIT D.
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City | LEBANON
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State | TN
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Zip | 37087
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Country | US
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Telephone | 855-522-8726
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Fax | 888-581-0336
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Authorized Official
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Title or Position | CEO/CFO
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Name | MR. KEVIN L. LAFURGE
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Credential |
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Telephone | 360-852-0302
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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 |
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License Number State |
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