Beta Biosciences, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BETA BIOSCIENCES, LLC

Doing business as

KINGDOM HEALTH LABORATORY

Practice address

1420 NW Vivion Rd
Kansas City, MO 64118-4555

Phone

(469) 995-7138

Fax

(469) 995-8238

NPI assigned

Mar 22, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keith J Gray

Title

Managing Partner

Phone

(469) 995-7792

Specialties & licenses 1

Addresses

Other names 1

• KINGDOM HEALTH LABORATORY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1245692169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681390",
            "city": "RIVERSIDE",
            "state": "MO",
            "postal_code": "641681390",
            "telephone_number": "469-995-7792",
            "fax_number": "469-995-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 NW VIVION RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184555",
            "telephone_number": "469-995-7138",
            "fax_number": "469-995-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETA BIOSCIENCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "469-995-7792"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KINGDOM HEALTH LABORATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.