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General NPI Number Information
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NPI Number | 1750768834
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Entity Type | Organization
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Legal Business Name | TITAN MOLECULAR LABORATORIES LLC
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 2296 W COMMODORE WAY STE 200
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City | SEATTLE
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State | WA
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Zip | 98199-1565
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Country | US
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Telephone | 206-257-5236
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Fax |
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Provider Business Mailing Address
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Address Line | 2296 W COMMODORE WAY STE 200
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City | SEATTLE
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State | WA
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Zip | 98199-1565
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Country | US
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Telephone | 206-257-5236
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Fax |
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | LAKSHMI KUMARI GAUR
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Credential | PHD
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Telephone | 206-290-8012
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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 | 603495658
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License Number State | WA
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