Organization
KENT PATHOLOGY LABORATORY PLLC
Active
Parent organization
KENT PATHOLOGY LABORATORY PLLC
Other names
Kent Pathology Laboratory LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENT PATHOLOGY LABORATORY PLLC
Authorized official
DR. WON KYU LEE M.D. (MEDICAL DIRECTOR)
(616) 774-0209
Entity
Organization
Contact information
Practice address
2650 HORIZON DR SE, SUITE B, GRAND RAPIDS, MI 49546-7519
(616) 458-1255
(616) 458-1292
Mailing address
2650 HORIZON DR SE, SUITE B, GRAND RAPIDS, MI 49546-7519
(616) 458-1255
(616) 458-1292
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
06/17/2010
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