# KENT PATHOLOGY LABORATORY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KENT PATHOLOGY LABORATORY PLLC
- **Other names:** Kent Pathology Laboratory LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740397124
- **Legal business name:** KENT PATHOLOGY LABORATORY PLLC
- **Authorized official:** DR. WON KYU LEE M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (616) 774-0209

## Contact information

- **Practice address:** 2650 HORIZON DR SE, SUITE B, GRAND RAPIDS, MI 49546-7519
- **Practice address phone:** (616) 458-1255
- **Practice address fax:** (616) 458-1292
- **Mailing address:** 2650 HORIZON DR SE, SUITE B, GRAND RAPIDS, MI 49546-7519
- **Mailing address phone:** (616) 458-1255
- **Mailing address fax:** (616) 458-1292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | NULL | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 06/17/2010