Organization
ADVANCED DRUG DETECTION II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WICKLUND (MANAGER)
(208) 734-2889
Entity
Organization
Contact information
Practice address
202 2ND AVE N, TWIN FALLS, ID 83301-6158
(208) 734-2889
(208) 734-0801
Mailing address
PO BOX 148, TWIN FALLS, ID 83303-0148
(208) 734-2889
(208) 734-0801
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
ID
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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