Basic Information
| Provider Information | |||||||||
| NPI: | 1225337249 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CYTOLAB PATHOLOGY SERVICES INC PS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6825 216TH ST SW | ||||||||
| Address2: | SUITE E | ||||||||
| City: | LYNNWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980367379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257128020 | ||||||||
| FaxNumber: | 4257128349 | ||||||||
| Practice Location | |||||||||
| Address1: | 6825 216TH ST SW | ||||||||
| Address2: | SUITE E | ||||||||
| City: | LYNNWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980367379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257128020 | ||||||||
| FaxNumber: | 4257128349 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2011 | ||||||||
| LastUpdateDate: | 03/16/2011 | ||||||||
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| AuthorizedOfficialLastName: | NAKONECHNY | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4257128020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | WA | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.