Organization
WILLOW STREET MEDICAL LAB LLC
Active
Other names
Willow Laboratories and Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL B MARCUS (PRESIDENT CEO)
(781) 268-2400
Entity
Organization
Contact information
Practice address
280 UNION ST, LYNN, MA 01901-1353
(781) 593-3480
Mailing address
280 UNION ST, LYNN, MA 01901-1353
(781) 268-2400
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2346
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805807
—
MA
Enumeration date
05/28/2006
Last updated
02/06/2013
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