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General NPI Number Information
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NPI Number | 1407060411
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Entity Type | Organization
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Legal Business Name | CELLNETIX LABS, LLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 12501 E MARGINAL WAY S STE 200
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City | TUKWILA
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State | WA
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Zip | 98168-2560
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Country | US
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Telephone | 206-576-6138
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Fax | 206-215-6090
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Provider Business Mailing Address
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Address Line | 1124 COLUMBIA ST SUITE 200
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City | SEATTLE
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State | WA
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Zip | 98104-2026
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Country | US
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Telephone | 206-576-6138
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Fax | 206-215-6090
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Authorized Official
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Title or Position | CFO
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Name | MR. DAVID KIEHN
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Credential |
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Telephone | 206-576-6138
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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 | 50D1067441
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License Number State | WA
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