Provider Demographics
NPI:1083887640
Name:LIBERTY DIAGNOSTICS
Entity Type:Organization
Organization Name:LIBERTY DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:SILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-429-5087
Mailing Address - Street 1:7111 ZENOBIA ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-5796
Mailing Address - Country:US
Mailing Address - Phone:303-429-5087
Mailing Address - Fax:303-429-5091
Practice Address - Street 1:7111 ZENOBIA ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-5796
Practice Address - Country:US
Practice Address - Phone:303-429-5087
Practice Address - Fax:303-429-5091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies