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NORTHWEST MEDICAL DIAGNOSTIC LABORATORY LLC
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Company Details
Legal Name:
NORTHWEST MEDICAL DIAGNOSTIC LABORATORY LLC
Jurisdiction:
WASHINGTON
Entity Type:
WA LIMITED LIABILITY COMPANY
Category:
DOMESTIC ENTITY
Status:
Administratively Dissolved
Formation/ Registration Date:
January 20th 2015
Date of Dissolution:
June 3rd 2019
Expiration date:
31 Jan 2019
UBI Number:
603 469 917
ZIP code:
98632
City:
Longview
County:
COWLITZ
Home State:
WASHINGTON
Principal Office Street Address:
720 14TH AVE, LONGVIEW, WA, 98632, UNITED STATES
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Registered Agent Information
Name
Role
Address
CARL LIAN
Registered Agent
111 STONEWAY LN, LONGVIEW, WA, 98632-5191, UNITED STATES
Key Officers & Management
Name
Role
CARL LIAN
Governing Person
National Provider Identifier
NPI Number:
1457739559
Link:
View on NPI website
Authorized Person:
Name:
CARL JEROME LIAN
Role:
CEO
Phone:
3604424129
Taxonomy:
Selected Taxonomy:
291U00000X - Clinical Medical Laboratory
Is Primary:
Yes
Contacts:
Phone:
+1 360-442-4129
Fax:
3604424130
Related by address
720 14TH AVE, LONGVIEW, WA, 98632, UNITED STATES
LC CLINICAL PATHOLOGY, P.S.
WA PROFESSIONAL SERVICE CORPORATION -
Administratively Dissolved
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