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General NPI Number Information
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NPI Number | 1396321022
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Entity Type | Organization
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Legal Business Name | SPECTRA LABORATORIES INC
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 1280 STATELINE RD E
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9486
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Country | US
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Telephone | 877-334-0021
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Fax | 800-716-5539
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Provider Business Mailing Address
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Address Line | 1280 STATELINE RD E
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9486
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Country | US
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Telephone | 877-334-0021
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Fax | 800-716-5539
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Authorized Official
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Title or Position | SENIOR VP AND MEDICAL DIRECTOR
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Name | ALEX RYDER
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Credential | MD
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Telephone | 877-334-0021
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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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