Provider Demographics
NPI:1740356872
Name:ZRT LABORATORY LLC
Entity type:Organization
Organization Name:ZRT LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,OWNER,CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-466-2445
Mailing Address - Street 1:8605 SW CREEKSIDE PLACE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7161
Mailing Address - Country:US
Mailing Address - Phone:503-466-2445
Mailing Address - Fax:503-645-1552
Practice Address - Street 1:8605 SW CREEKSIDE PLACE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7161
Practice Address - Country:US
Practice Address - Phone:503-466-2445
Practice Address - Fax:503-645-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR107280Medicare PIN