Organization
CASCADE MEDICAL TESTING LAB, INC.
Active
Parent organization
ROBERT DEJONGE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROBERT DEJONGE
Authorized official
MR. ROBERT DEJONGE MD (PRESIDENT)
(616) 956-6090
Entity
Organization
Contact information
Practice address
2251 E PARIS AVE SE, GRAND RAPIDS, MI 49546-2431
(616) 956-6090
Mailing address
PO BOX 88247, KENTWOOD, MI 49518-0247
(616) 734-0335
(616) 949-8540
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
11/21/2006
Last updated
10/19/2007
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