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General NPI Number Information
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NPI Number | 1558569517
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Entity Type | Organization
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Legal Business Name | YOUR CHOICE LABORATORY, INC.
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 500 MAIN ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-2130
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Country | US
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Telephone | 970-380-8766
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Fax |
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Provider Business Mailing Address
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Address Line | 217 CHEYENNE ST
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City | FORT MORGAN
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State | CO
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Zip | 80701-4016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | MRS. LUANNE PRICE ALBERT
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Credential | MT (ASCP)
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Telephone | 970-867-6531
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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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