Organization
SPECIALTY LABS PLLC
Active
Organization
SPECIALTY LABS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMARA SIMON MD (OWNER/LAB DIRECTOR)
(208) 939-3505
Entity
Organization
Contact information
Practice address
951 E PLAZA DR, SUITE 170, EAGLE, ID 83616
(208) 939-3505
(939) 939-3507
Mailing address
951 E PLAZA DR, SUITE 170, EAGLE, ID 83616
(208) 939-3505
(939) 939-3507
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
ID
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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