NPI 1609123330

Longevity Laboratory, LLC

Organisation Clinical Medical Laboratory Kirkland, WA

Practice location

Address: 9757 NE Juanita Dr 202, Kirkland, WA 98034-4299
Phone: (425) 605-8715
Fax: (425) 654-0211

Authorised official

Name: Jerry Nelson Mixon
Title: Medical Director
Phone: (425) 605-8715

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X

Other Clinical Medical Laboratory providers in Washington →

Registry record

NPI: 1609123330
Entity type: Organization
NPI issued: 13 Aug 2012
Record last updated: 13 Aug 2012

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.