MEDICARE: LABS, INC

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
1	291U00000X	Clinical Medical Laboratory	26D1086087	MO

General Provider Information

NPI Number	:	1568612216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABS, INC

Provider Business Mailing Address
First Line	:	6933-B SOUTH REVERE PARKWAY
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112
Country	:	US
Telephone Number	:	720-528-4770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 HIGHLANDS PLAZA DR E
Second Line	:	SUITE 100
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1340
Country	:	US
Telephone Number	:	720-488-4460
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	ELIZABETH HEARTY
Credential	:
Telephone Number	:	720-528-4770

Provider Enumeration Date	:	09/30/2008
Last Update Date	:	09/30/2008

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