Organization
BASELINE LABORATORY SERVICES
Active
Parent organization
BASELINE LABORATORY SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
BASELINE LABORATORY SERVICES
Authorized official
MARGARITA R MOORE (CREDENTIALING)
(541) 414-0362
Entity
Organization
Contact information
Practice address
537 MURPHY RD STE B, MEDFORD, OR 97504-8187
(541) 414-0362
(541) 200-2269
Mailing address
1744 E MCANDREWS RD STE D, MEDFORD, OR 97504-5576
(541) 414-0362
(541) 200-2269
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38D2275224
CLIA
OR
05
—
500821822
—
OR
Enumeration date
04/13/2023
Last updated
08/22/2023
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