Basic Information
| Provider Information | |||||||||
| NPI: | 1174942957 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASCENDANT LABORATORIES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 827 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980090827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255636261 | ||||||||
| FaxNumber: | 4257745171 | ||||||||
| Practice Location | |||||||||
| Address1: | 2800 NORTHUP WAY STE 100 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980041440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255636261 | ||||||||
| FaxNumber: | 4257745171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2014 | ||||||||
| LastUpdateDate: | 11/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | LEE | ||||||||
| AuthorizedOfficialFirstName: | JAE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4257741538 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 50D2073372 | WA | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.