Provider Demographics
NPI:1164001103
Name:TRUQUALITY HOMEBOUND LABS
Entity Type:Organization
Organization Name:TRUQUALITY HOMEBOUND LABS
Other - Org Name:TRUQUALITY LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMIST/INSTRUCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BOSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:470-871-9440
Mailing Address - Street 1:6301 ROCKHILL RD STE 107A
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1161
Mailing Address - Country:US
Mailing Address - Phone:470-871-9440
Mailing Address - Fax:
Practice Address - Street 1:6301 ROCKHILL RD STE 107A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1161
Practice Address - Country:US
Practice Address - Phone:470-871-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1164001103Medicaid
MO1164001103OtherAETNA
MO1164001103OtherUNITED HEALTHCARE
MO1164001103OtherBLUE CROSS/BLE SHIELD OF KC
MO1164001103OtherCIGNA
MO1164001103OtherHUMANA