Provider Demographics
NPI:1881284867
Name:JUNEAU BIOSCIENCES, LLC
Entity type:Organization
Organization Name:JUNEAU BIOSCIENCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-478-1645
Mailing Address - Street 1:1885 W 2100 S STE 100
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-1303
Mailing Address - Country:US
Mailing Address - Phone:801-478-1645
Mailing Address - Fax:
Practice Address - Street 1:1885 W 2100 S STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-1303
Practice Address - Country:US
Practice Address - Phone:801-478-1645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory