Provider Demographics
NPI:1144201591
Name:NORTH HILL LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:NORTH HILL LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:NEVLING
Authorized Official - Suffix:
Authorized Official - Credentials:PA C
Authorized Official - Phone:319-754-1555
Mailing Address - Street 1:825 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4920
Mailing Address - Country:US
Mailing Address - Phone:319-752-8422
Mailing Address - Fax:319-752-4860
Practice Address - Street 1:825 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-4920
Practice Address - Country:US
Practice Address - Phone:319-752-8422
Practice Address - Fax:319-752-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1601011985291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00220337OtherRAILROAD MEDICARE
IA0420570Medicaid
35428OtherBLUE CROSS
I10308Medicare ID - Type Unspecified