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General NPI Number Information
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NPI Number | 1477828838
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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 | 03/19/2012
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 800 W 5TH AVE
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City | SPOKANE
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State | WA
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Zip | 99204-2803
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Country | US
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Telephone | 866-236-8296
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Fax |
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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 | 866-236-8296
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. JOHN RANDY BOREK
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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 |
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License Number State |
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