Organization
INTERPATH LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GOLDIE MANDELLA (MANAGER, BILLING OPERATIONS)
(541) 278-4743
Entity
Organization
Contact information
Practice address
2460 SW PERKINS AVENUE, PENDLETON, OR 97801
(541) 276-6700
Mailing address
PO BOX 1208, PENDLETON, OR 97801-0780
(541) 276-6700
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
38D0628506
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7018906
—
OR
Enumeration date
06/03/2006
Last updated
12/28/2015
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