Physicians Reference Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PHYSICIANS REFERENCE LABORATORY LLC

Practice address

3840 W 75TH St
Prairie Village, KS 66208-4126

Phone

(913) 338-4070

Fax

(913) 338-4245

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gregory J Keitges

Title

Coo

Phone

(913) 338-4070

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1285753434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 W 110TH ST",
            "address_2": "STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102304",
            "telephone_number": "913-338-4070",
            "fax_number": "913-338-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 W 75TH ST",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662084126",
            "telephone_number": "913-338-4070",
            "fax_number": "913-338-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS REFERENCE LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "KEITGES",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "913-338-4070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690008419",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Clinical Medical Laboratory in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.