Medical Diagnostic Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

MTS-4979 Issued in WA

Legal business name

MEDICAL DIAGNOSTIC LABORATORY INC

Practice address

409 Eleanor Lane
Building B
Mount Vernon, WA 98273

Phone

(360) 542-3232

Fax

(360) 424-6326

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Kathy Pfeiffer

Title

Bookkeeper

Phone

(360) 542-3232

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James L Biesecker, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Mount Vernon, WA
  • NPI 1548346042
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386704310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E COLLEGE WAY",
            "address_2": "SUITE A, PMB 276",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735637",
            "telephone_number": "360-542-3232",
            "fax_number": "360-424-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 ELEANOR LANE",
            "address_2": "BUILDING B",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "98273",
            "telephone_number": "360-542-3232",
            "fax_number": "360-424-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PFEIFFER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "360-542-3232"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WA",
            "license": "MTS-4979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MTS-4979",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robbie Rae McManus, MS LMHC
• Andrew McMurray, ARNP
• Sally McPherson
• Cheryl Lynn McRill, M.D.
• Joel A Meckstroth, ARNP
• Alejandro Jude Pabustan Medina, MD
• Casey Ray Medina, MD
• Graham Meeks
• Navid Mehraban, MD
• Melanated Maternity Essentials LLC. (The Doula Centered Network)

• Clinical Medical Laboratory in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Clinical Medical Laboratory in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.