Organization
PATHOLOGISTS REGIONAL LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOU ANN LAZZARINI (ADMINISTATIVE SUPERVISOR)
(208) 798-3635
Entity
Organization
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 746-0516
(208) 746-4989
Mailing address
415 6TH STREET, LEWISTON, ID 83501
(208) 746-0516
(208) 746-4989
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
I033
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002335400
—
ID
05
—
002335700
—
ID
05
—
7003411
—
WA
05
—
7840606
—
WA
Enumeration date
06/01/2006
Last updated
03/02/2020
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