Organization
LANDBANK LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PINEGAR (OWNER)
(208) 522-6155
Entity
Organization
Contact information
Practice address
1020 LAND BANK ST, SUITE B, IDAHO FALLS, ID 83402-1809
(208) 522-6155
(208) 522-6156
Mailing address
1020 LAND BANK ST, SUITE B, IDAHO FALLS, ID 83402-1809
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
P1621
ID
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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