Provider Demographics
NPI:1265777973
Name:PRECISION ANALYTICAL CONSULTING AND LABORATORY, INC.
Entity type:Organization
Organization Name:PRECISION ANALYTICAL CONSULTING AND LABORATORY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-687-2050
Mailing Address - Street 1:3138 NE RIVERGATE ST
Mailing Address - Street 2:301C
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8488
Mailing Address - Country:US
Mailing Address - Phone:503-687-2050
Mailing Address - Fax:503-687-2052
Practice Address - Street 1:3138 NE RIVERGATE ST
Practice Address - Street 2:301C
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-8488
Practice Address - Country:US
Practice Address - Phone:503-687-2050
Practice Address - Fax:503-687-2052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR38D2047310291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory