Provider Demographics
NPI:1285011403
Name:GOLDEN TOXICOLOGY,LLC
Entity Type:Organization
Organization Name:GOLDEN TOXICOLOGY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-944-1247
Mailing Address - Street 1:2020 8TH AVE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4657
Mailing Address - Country:US
Mailing Address - Phone:541-944-1247
Mailing Address - Fax:541-482-0964
Practice Address - Street 1:2020 8TH AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-4657
Practice Address - Country:US
Practice Address - Phone:541-944-1247
Practice Address - Fax:541-482-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory