Organization
MEDICAL CENTER LABORATORY, INC. PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W. ONSTAD M.D. (PRESIDENT/PARTNER)
(509) 248-1831
Entity
Organization
Contact information
Practice address
401 S 12TH AVE, YAKIMA, WA 98902-3142
(509) 248-1831
Mailing address
401 S 12TH AVE, YAKIMA, WA 98902-3142
(509) 248-1831
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
MTS-0302
WA
246QC2700X
Cytotechnology Specialist/Technologist
MTS-0302
WA
246QH0600X
Histology Specialist/Technologist
MTS-0302
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D0638408
CLIA
WA
05
—
7811003
—
WA
Enumeration date
08/30/2006
Last updated
03/24/2010
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