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General NPI Number Information
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NPI Number | 1992253249
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Entity Type | Organization
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Legal Business Name | APOLLO LABORATORY SCIENCE AND TECHNOLOGY SERVICES
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 1718 ALEXANDRIA DR STE 300
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City | LEXINGTON
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State | KY
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Zip | 40504-3144
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Country | US
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Telephone | 859-320-0412
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Fax | 888-977-1886
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Provider Business Mailing Address
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Address Line | 1718 ALEXANDRIA DR STE 300
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City | LEXINGTON
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State | KY
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Zip | 40504-3144
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Country | US
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Telephone | 859-320-0412
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Fax | 888-977-1886
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Authorized Official
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Title or Position | CREDENTIALING ADMINISTRATIVE
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Name | KIM D SHEETS
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Credential |
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Telephone | 859-320-0412
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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 | 200377
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License Number State | KY
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