Provider Demographics
NPI:1750739041
Name:MOLECULAR VISION LABORATORY
Entity type:Organization
Organization Name:MOLECULAR VISION LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEI WEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FACMG
Authorized Official - Phone:720-880-8329
Mailing Address - Street 1:1920 NE STUCKI AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6977
Mailing Address - Country:US
Mailing Address - Phone:503-858-2674
Mailing Address - Fax:503-227-3157
Practice Address - Street 1:1920 NE STUCKI AVE STE 150
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-6977
Practice Address - Country:US
Practice Address - Phone:503-858-2674
Practice Address - Fax:503-227-3157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory