Provider Demographics
NPI:1750989307
Name:LIGHT POINT LABS LLC
Entity type:Organization
Organization Name:LIGHT POINT LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TORNSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-712-0454
Mailing Address - Street 1:56 STILES RD STE 204
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4807
Mailing Address - Country:US
Mailing Address - Phone:603-458-2840
Mailing Address - Fax:
Practice Address - Street 1:56 STILES RD STE 204
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4807
Practice Address - Country:US
Practice Address - Phone:603-458-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory