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General NPI Number Information
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NPI Number | 1467023499
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Entity Type | Organization
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Legal Business Name | PCR-DX OF COLORADO, LLC
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2301 RESEARCH BLVD STE 201-202
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City | FORT COLLINS
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State | CO
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Zip | 80526-1825
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Country | US
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Telephone | 205-861-1951
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Fax | 855-871-0978
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Provider Business Mailing Address
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Address Line | 2112 11TH AVE S STE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35205-2843
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Country | US
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Telephone | 205-882-5227
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Fax | 205-588-0502
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Authorized Official
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Title or Position | CFO
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Name | ROB LILLY
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Credential |
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Telephone | 205-706-7727
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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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