Northway Medical Laboratory, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

907046 Issued in AK

Legal business name

NORTHWAY MEDICAL LABORATORY, INC.

Practice address

991 North Hermon Rd.
Suite 400
Wasilla, AK 99654

Phone

(907) 357-2993

NPI assigned

Feb 15, 2008

Last updated

Feb 15, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cecilia De Leon

Title

Owner

Phone

(907) 830-0518

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1265600936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 NORTH HERMON RD.",
            "address_2": "SUITE 400",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-357-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 NORTH HERMON RD.",
            "address_2": "SUITE 400",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-357-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWAY MEDICAL LABORATORY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "DE LEON",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-830-0518"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AK",
            "license": "907046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Clinical Medical Laboratory in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.