Organization
SIBO TESTING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRANE J HOLMES (OWNER)
(971) 266-8383
Entity
Organization
Contact information
Practice address
1820 SW VERMONT ST STE G, PORTLAND, OR 97219-1945
(971) 266-8383
Mailing address
1820 SW VERMONT ST STE G, PORTLAND, OR 97219-1945
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/24/2019
Last updated
10/24/2019
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