Provider Demographics
NPI:1447631890
Name:XENO LABORATORY LLC
Entity type:Organization
Organization Name:XENO LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VUTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-237-1115
Mailing Address - Street 1:PO BOX 6015
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-6015
Mailing Address - Country:US
Mailing Address - Phone:253-237-1115
Mailing Address - Fax:253-874-7114
Practice Address - Street 1:34618 11TH PL S STE 204
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6792
Practice Address - Country:US
Practice Address - Phone:253-237-1115
Practice Address - Fax:253-874-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory