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NPI Code Detail

MEDICARE: COMPREHENSIVE PATHOLOGY SERVICES LC

MEDICARE: COMPREHENSIVE PATHOLOGY SERVICES LC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory26D0045374MO
2291U00000XClinical Medical Laboratory26D0437653MO
3174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1042938OTHERMOHEALTH ALLIANCE
2CI2882OTHERTRAVELERS
329381OTHERGHP
4373987OTHERHEALTH LINK
57556OTHERMOHEALTHCARE USA
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
79801344OTHERUHC

General Provider Information

NPI Number : 1609859560
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE PATHOLOGY SERVICES LC
Provider Business Mailing Address
First Line : PO BOX 842049
Second Line :
City : KANSAS CIY
State : MO
Zip : 64184-2049
Country : US
Telephone Number : 314-821-8055
Fax Number : 314-821-1833
Provider Business Practice Location Address
First Line : 1015 BOWLES AVE
Second Line :
City : FENTON
State : MO
Zip : 63026-2394
Country : US
Telephone Number : 636-496-2720
Fax Number : 314-821-1833
Authorized Official
Title or Position : DIRECTOR
Name : KATHRYN LAW
Credential : M.D.
Telephone Number : 314-768-8202
Provider Enumeration Date : 11/23/2005
Last Update Date : 03/12/2025

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Directions to “COMPREHENSIVE PATHOLOGY SERVICES LC ” Practice Location

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