NPI 1487789343

Medical Lab Service

Organisation Clinical Medical Laboratory Burley, ID

Practice location

Address: 1501 Hiland Ave Suite J, Burley, ID 83318-2682
Phone: (208) 678-5215
Fax: (208) 678-1472

Authorised official

Name: Wendell L Wells
Title: Director
Phone: (208) 678-8899

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X Licence PO33 (ID)

Other Clinical Medical Laboratory providers in Idaho →

Registry record

NPI: 1487789343
Entity type: Organization
NPI issued: 22 Feb 2007
Record last updated: 9 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.