Provider Demographics
NPI:1891758314
Name:LABORATORY MEDICINE SPECIALISTS OF DULUTH
Entity type:Organization
Organization Name:LABORATORY MEDICINE SPECIALISTS OF DULUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNDEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-288-8325
Mailing Address - Street 1:915 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2107
Mailing Address - Country:US
Mailing Address - Phone:218-249-5208
Mailing Address - Fax:218-726-3007
Practice Address - Street 1:1346 W ARROWHEAD RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-2218
Practice Address - Country:US
Practice Address - Phone:800-288-8325
Practice Address - Fax:218-726-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN854291U00000X
207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN218893600OtherUS POSTAL SERVICE
MN2098OtherHEALTHPARTNERS
WI3986OtherATRIUM GROUP HEALTH
MN1133017OtherMEDICA
MN10447D011OtherUCARE
MN42512LAOtherBLUES
WI32787100Medicaid
MN596145OtherAMERICA PPO
MN342312300Medicaid
WI32787100Medicaid