Mat-Su Medical Laboratory, LLC.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MAT-SU MEDICAL LABORATORY, LLC.

Practice address

224 N Yenlo St Ste 3B
Wasilla, AK 99654-7195

Phone

(907) 376-1122

NPI assigned

Sep 18, 2012

Organization subpart

No

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

Authorized official

Name

Pauline Bullard

Title

Owner

Phone

(907) 376-1122

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861742793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N YENLO ST STE 3B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547195",
            "telephone_number": "907-376-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N YENLO ST STE 3B",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547195",
            "telephone_number": "907-376-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT-SU MEDICAL LABORATORY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BULLARD",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-376-1122"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mat-Su Birth Center, LLC
• Mat-Su Chiropractic LLC (Mat-Su Chiropractic)
• Mat-Su Community Pediatrics, P.C.
• Mat-Su Dental Center, Inc.
• Mat-Su Integrative Medicine
• Mat-Su Mental Health LLC
• Mat-Su Midwifery Inc
• Mat-Su Neurology, LLC
• Mat-Su Pediatric Physical Therapy LLC
• Mat-Su Services for Children & Adults

• 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 Jul 21, 2022; 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.