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NPI Code Detail

MEDICARE: PHYSICIANS REFERENCE LABORATORY LLC

MEDICARE: PHYSICIANS REFERENCE LABORATORY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1568489524
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIANS REFERENCE LABORATORY LLC
Provider Business Mailing Address
First Line : 7800 W 110TH ST
Second Line : STE 200
City : OVERLAND PARK
State : KS
Zip : 66210-2304
Country : US
Telephone Number : 913-338-4070
Fax Number : 913-338-4245
Provider Business Practice Location Address
First Line : 7800 W 110TH ST
Second Line : STE 200
City : OVERLAND PARK
State : KS
Zip : 66210-2304
Country : US
Telephone Number : 913-338-4070
Fax Number : 913-338-4245
Authorized Official
Title or Position : COO
Name : MR. GREGORY J KEITGES
Credential :
Telephone Number : 913-338-4070
Provider Enumeration Date : 07/16/2006
Last Update Date : 11/29/2007

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Directions to “PHYSICIANS REFERENCE LABORATORY LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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