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General NPI Number Information
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NPI Number | 1659837961
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Entity Type | Organization
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Legal Business Name | FIDALAB
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Dates
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Enumeration Date | 02/12/2019
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Last Update Date | 06/09/2023
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Provider Practice Location Address
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Address Line | 1128 NW 52ND ST STE 401
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City | SEATTLE
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State | WA
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Zip | 98107-5129
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Country | US
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Telephone | 425-559-0680
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Fax |
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Provider Business Mailing Address
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Address Line | 1128 NW 52ND ST STE 401
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City | SEATTLE
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State | WA
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Zip | 98107-5129
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Country | US
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Telephone | 206-226-8960
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Fax |
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Authorized Official
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Title or Position | CHIEF OF SCIENTIFIC OFFICER
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Name | QINGHUA QUINNE FENG
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Credential | PHD
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Telephone | 206-245-6349
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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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