MEDICARE: KEVIN MERRY MLS(ASCP)

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	246QL0900X	Laboratory Management Specialist/Technologist

General Provider Information

NPI Number	:	1811821648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN MERRY MLS(ASCP)

Provider Business Mailing Address
First Line	:	226 MCFARLAND CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2078
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 MCFARLAND CT
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2078
Country	:	US
Telephone Number	:	319-321-0212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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