MEDICARE: APOLLO LABORATORY SCIENCE AND TECHNOLOGY SERVICES

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
1	291U00000X	Clinical Medical Laboratory	200377	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	K226080	OTHER	KY	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992253249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOLLO LABORATORY SCIENCE AND TECHNOLOGY SERVICES

Provider Business Mailing Address
First Line	:	1718 ALEXANDRIA DR STE 300
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3144
Country	:	US
Telephone Number	:	859-320-0412
Fax Number	:	888-977-1886

Provider Business Practice Location Address
First Line	:	1718 ALEXANDRIA DR STE 300
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3144
Country	:	US
Telephone Number	:	859-320-0412
Fax Number	:	888-977-1886

Authorized Official
Title or Position	:	CREDENTIALING ADMINISTRATIVE
Name	:	KIM D SHEETS
Credential	:
Telephone Number	:	859-320-0412

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	04/12/2022

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Directions to “APOLLO LABORATORY SCIENCE AND TECHNOLOGY SERVICES ” Practice Location

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