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General NPI Number Information
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NPI Number | 1952385056
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Entity Type | Organization
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Legal Business Name | TRI-CITIES LABORATORY, LLC
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 7131 W GRANDRIDGE BLVD
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City | KENNEWICK
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State | WA
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Zip | 99336
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Country | US
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Telephone | 509-736-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2688
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City | SPOKANE
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State | WA
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Zip | 99220-2688
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Country | US
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Telephone | 509-736-0100
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KIMBERLY T WILLIAMS
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Credential |
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Telephone | 800-222-7566
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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 | MTS-0399
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License Number State | WA
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