Southlake Clinic Pathology

LBN: Southlake Clinic Inc Ps
Southlake Clinic Pathology is an health care organization with primary practice located at 4011 Talbot Rd S Suite 500, Renton WA 98055-5773. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as the primary health care specialty. Southlake Clinic Inc Ps can be contacted via phone (425) 251-5110, or through Larson, Marianne via phone (425) 251-5110.

Contact Information

Primary practice address
4011 Talbot Rd S Suite 500 Renton WA 98055-5773
Phone: (425) 251-5110
Fax: (425) 793-4710
Website:
Map and Directions
Authorized official contact:
Name: Larson, Marianne
Phone: (425) 251-5110

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X MD00015542 Washington

Profile Details

NPI number 1538394234
LBN Legal business name Southlake Clinic Inc Ps
DBA Doing business as Southlake Clinic Pathology
Authorized official Larson, Marianne
Entity Organization
Organization subpart 1 No
Enumeration date May 26th, 2009
Last updated Aug 6th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538394234 NPPES
Washington Other 0057600 DEPT OF L&I
Washington MEDICAID 7147564 DEPT OF L&I

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