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General NPI Number Information
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NPI Number | 1649407792
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Entity Type | Organization
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Legal Business Name | LABORATORY SERVICES COOPERATIVE
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 723B NE RIDDELL RD
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City | BREMERTON
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State | WA
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Zip | 98310-3030
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Country | US
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Telephone | 360-475-9091
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Fax | 360-373-1749
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Provider Business Mailing Address
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Address Line | 14730 NE 8TH ST
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City | BELLEVUE
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State | WA
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Zip | 98007-4116
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Country | US
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Telephone | 425-460-4552
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Fax | 425-653-6124
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Authorized Official
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Title or Position | REVENUE CYCLE DIRECTOR
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Name | MS. DEBBIE HART
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Credential |
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Telephone | 425-460-4552
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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 | 50D1067112
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License Number State | WA
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