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General NPI Number Information
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NPI Number | 1215930987
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC LABORATORY SERVICES, INC
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 99-859 IWAIWA ST
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City | AIEA
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State | HI
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Zip | 96701-3267
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Country | US
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Telephone | 808-589-5107
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Fax | 808-589-5233
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Provider Business Mailing Address
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Address Line | 99-859 IWAIWA ST
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City | AIEA
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State | HI
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Zip | 96701-3267
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Country | US
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Telephone | 808-589-5107
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Fax | 808-589-5233
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Authorized Official
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Title or Position | VP FINANCE
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Name | REBECCA S ROBERTS
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Credential |
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Telephone | 808-589-5175
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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 | HI
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