Provider Demographics
NPI:1275601767
Name:KANSAS HEALTH AND ENVIRONMENTAL LABORATORIES
Entity Type:Organization
Organization Name:KANSAS HEALTH AND ENVIRONMENTAL LABORATORIES
Other - Org Name:KANSAS DIVISION OF HEALTH AND ENVIRONMENTAL LABORATORIES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:785-296-1619
Mailing Address - Street 1:6700 SW TOPEKA BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66620-0001
Mailing Address - Country:US
Mailing Address - Phone:785-296-1620
Mailing Address - Fax:785-296-1641
Practice Address - Street 1:6700 SW TOPEKA BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66620-0001
Practice Address - Country:US
Practice Address - Phone:785-296-1620
Practice Address - Fax:785-296-1641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100008080CMedicaid