Organization
NORTHWAY MEDICAL LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA DE LEON (OWNER)
(907) 830-0518
Entity
Organization
Contact information
Practice address
991 NORTH HERMON RD., SUITE 400, WASILLA, AK 99654
(907) 357-2993
Mailing address
991 NORTH HERMON RD., SUITE 400, WASILLA, AK 99654
(907) 357-2993
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
907046
AK
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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