Provider Demographics
NPI:1073936183
Name:ANALYTICAL EDGE LABORATORIES LLC
Entity Type:Organization
Organization Name:ANALYTICAL EDGE LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:855-243-3343
Mailing Address - Street 1:120 NE 26TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-2705
Mailing Address - Country:US
Mailing Address - Phone:855-243-3343
Mailing Address - Fax:405-253-5816
Practice Address - Street 1:120 NE 26TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-2705
Practice Address - Country:US
Practice Address - Phone:855-243-3343
Practice Address - Fax:405-253-5816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37D2070976291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory