Renew Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

RENEW LABS, LLC

Doing business as

Renew Labs

Practice address

286 US Highway 23 N
Prestonsburg, KY 41653-8732

Phone

(606) 653-1503

NPI assigned

Nov 28, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Eugene Sisco III

Title

Managing Member

Phone

(606) 653-1503

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Renew Labs Doing business as

Locations

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

{
    "created_epoch": "1417132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1841697398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 VENTERS LANE",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "41501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 US HIGHWAY 23 N",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416538732",
            "telephone_number": "606-653-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-28",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "SISCO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "606-653-1503",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "18D2090590",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "291U0000X",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100331250",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Labs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renew Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chandler Reeves
• Connor Reeves, CHW
• Mary Reffitt, LCSW
• Jeremy Reid
• Deanna Reiff
• Carolyn Reynolds
• Jesse Reynolds
• Kimberly Reynolds
• Lisa Reynolds
• Maria Reynolds

• Clinical Medical Laboratory in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; 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.