Medical Lab Service

LBN: Medical Lab Service
Medical Lab Service is an health care organization with primary practice located at 1501 Hiland Ave Suite J, Burley ID 83318-2682. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Medical Lab Service can be contacted via phone (208) 678-5215, or through Wells, Wendell L via phone (208) 678-8899.

Contact Information

Primary practice address
1501 Hiland Ave Suite J Burley ID 83318-2682
Phone: (208) 678-5215
Fax: (208) 678-1472
Website:
Map and Directions
Authorized official contact:
Name: Wells, Wendell L Doctor of Medicine (MD)
Phone: (208) 678-8899

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X PO33 Idaho

Profile Details

NPI number 1487789343
LBN Legal business name Medical Lab Service
DBA Doing business as
Authorized official Wells, Wendell L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 22nd, 2007
Last updated Dec 9th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487789343 NPPES
Idaho MEDICAID 808196400

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