Organization
ROSE CITY LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J HUSON (MANAGING MEMBER)
(503) 307-0096
Entity
Organization
Contact information
Practice address
7200 SE JOHNSON CREEK BLVD, PORTLAND, OR 97206-9332
(503) 307-0096
Mailing address
7200 SE JOHNSON CREEK BLVD, PORTLAND, OR 97206-9332
(503) 307-0096
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
07/27/2020
Last updated
08/05/2020
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