Medical Lab Service

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

PO33 Issued in ID

Legal business name

MEDICAL LAB SERVICE

Practice address

1501 Hiland Ave
Suite J
Burley, ID 83318-2682

Phone

(208) 678-5215

Fax

(208) 678-1472

NPI assigned

Feb 22, 2007

Last updated

Dec 9, 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

Dr. Wendell L Wells, MDNPI 1902848922

Title

Director

Phone

(208) 678-8899

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wendell Lee Wells, M.D.

  • Family Medicine Physician
  • Burley, ID
  • NPI 1902848922
  Authorized official Same address or phone

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1487789343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "SUITE J",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-678-5215",
            "fax_number": "208-678-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "address_2": "SUITE J",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-678-5215",
            "fax_number": "208-678-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LAB SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-678-8899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ID",
            "license": "PO33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor McAllister, PA-C
• Ryan Patrick McCormick, P.T., D.P.T.
• Mary Irene McGinnis, LMSW
• Debra Leanor McKnight
• Brent Lee McMillan, P.T.
• Clea K. Mefford, RN MSN CRNP
• Heather M Meyers, PHARMD
• Michael P. Klett, D.O., P.C.
• Dennis J Michaelson, DMD MS
• Bryce Wayne Millar, M.D.

• Clinical Medical Laboratory in Burley, ID
• Providers in Burley, ID by specialty
• Clinical Medical Laboratory in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.