Organization
WILLOW STREET MEDICAL LABORATORY LLC
Active
Organization
WILLOW STREET MEDICAL LABORATORY LLC
Active
Parent organization
WILLOW STREET MEDICAL LABORATORY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLOW STREET MEDICAL LABORATORY LLC
Authorized official
BRIAN J STRASNICK PHD JD (CEO PRESIDENT)
(781) 268-2400
Entity
Organization
Contact information
Practice address
200 MAIN STREET, SUITE 220, PAWTUCKET, RI 02860
(401) 721-0970
(401) 721-9931
Mailing address
200 MAIN STREET, SUITE 220, PAWTUCKET, RI 02860
(401) 721-0970
(401) 721-9931
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WS60052
—
RI
Enumeration date
12/17/2007
Last updated
12/17/2007
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