Provider Demographics
NPI:1659480291
Name:PRIME DIAGNOSTICS INC
Entity Type:Organization
Organization Name:PRIME DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-483-5108
Mailing Address - Street 1:7307 N DIVISION ST # 204
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6545
Mailing Address - Country:US
Mailing Address - Phone:509-483-5108
Mailing Address - Fax:509-484-8427
Practice Address - Street 1:7307 N DIVISION ST # 204
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6545
Practice Address - Country:US
Practice Address - Phone:509-483-5108
Practice Address - Fax:509-484-8427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory