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General NPI Number Information
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NPI Number | 1972289775
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Entity Type | Organization
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Legal Business Name | NORTH SPRING LAB, LLC
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 7828 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920
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Country | US
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Telephone | 719-277-8378
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Fax | 719-277-8353
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Provider Business Mailing Address
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Address Line | 7828 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920
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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 | SENIOR LABORATORY SUPERVISOR
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Name | TERRA RUNYAN
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Credential |
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Telephone | 719-277-8378
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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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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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