Healthcare Provider Details
I. General information
NPI: 1467105890
Provider Name (Legal Business Name): CORE TESTING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2022
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 NE FLORENCE AVE
LEES SUMMIT MO
64086-5875
US
IV. Provider business mailing address
4050 PENNSYLVANIA AVE. STE 115 #190
KANSAS CITY MO
64111
US
V. Phone/Fax
- Phone: 816-405-9877
- Fax:
- Phone: 816-405-9877
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ASHLEY
M
BURRESS
Title or Position: PHARMACIST
Credential: PHARM D
Phone: 314-359-1803