Provider Demographics
NPI:1881740306
Name:SALIVA TESTING AND REFERENCE LAB, INC
Entity type:Organization
Organization Name:SALIVA TESTING AND REFERENCE LAB, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HOFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DABCC
Authorized Official - Phone:206-217-0911
Mailing Address - Street 1:PO BOX 771
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-0771
Mailing Address - Country:US
Mailing Address - Phone:206-217-0911
Mailing Address - Fax:
Practice Address - Street 1:562 1ST AVE S
Practice Address - Street 2:SUITE 703
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3820
Practice Address - Country:US
Practice Address - Phone:206-217-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMTS3640 CAT A291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory