Organization
WILLOW STREET MEDICAL LAB LLC
Active
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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