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General NPI Number Information
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NPI Number | 1568882454
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Entity Type | Organization
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Legal Business Name | OUS OREGON STATE UNIVERSITY
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 04/18/2014
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Provider Practice Location Address
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Address Line | 108 SW MEMORIAL PL OSU STUDENT HEALTH SERVICES LABORATORY
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City | CORVALLIS
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State | OR
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Zip | 97331-8667
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Country | US
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Telephone | 541-737-7548
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Fax | 541-737-9336
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Provider Business Mailing Address
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Address Line | 108 SW MEMORIAL PL OSU STUDENT HEALTH SERVICES LABORATORY
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City | CORVALLIS
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State | OR
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Zip | 97331-8667
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Country | US
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Telephone | 541-737-7548
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Fax | 541-737-9336
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR ADMIN SERVICES
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Name | MR. GEORGE VOSS
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Credential |
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Telephone | 541-737-4619
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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 | 38D0856060
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License Number State | OR
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