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Longevity Laboratory, LLC

Clinical Medical Laboratory in Kirkland, WA · enumerated 2012 · authorized official Jerry Mixon, Medical Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1609123330

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Registry record

Entity type Organization (Type 2)
Legal business name Longevity Laboratory, LLC
Practice address 9757 Ne Juanita Dr, 202, Kirkland, WA, 98034
Phone (425) 605-8715
Fax (425) 654-0211
Enumeration date Aug 13, 2012
Last updated in NPPES Aug 13, 2012

Taxonomy & classification

291U00000X Clinical Medical Laboratory Laboratories Primary

Authorized official

Name Jerry Mixon
Title Medical Director
Phone (425) 605-8715

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Longevity Laboratory, LLC?
The NPI for Longevity Laboratory, LLC is 1609123330, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Longevity Laboratory, LLC?
NPPES lists Jerry Mixon (Medical Director) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-08-13.