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General NPI Number Information
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NPI Number | 1174167597
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Entity Type | Organization
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Legal Business Name | GLOBAL REACH LABS, LLC
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 3400 E BAYAUD AVE STE 280
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City | DENVER
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State | CO
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Zip | 80209-2927
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Country | US
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Telephone | 561-373-0577
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 850067
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City | RICHARDSON
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State | TX
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Zip | 75085-0067
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Country | US
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Telephone | 561-373-0577
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEITH GRAY
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Credential |
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Telephone | 561-373-0577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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