Provider Demographics
NPI:1326328238
Name:ALLIANCE LABS, LLC
Entity Type:Organization
Organization Name:ALLIANCE LABS, LLC
Other - Org Name:LANDMARK TOXICOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FOSTER
Authorized Official - Middle Name:
Authorized Official - Last Name:OCKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-219-2828
Mailing Address - Street 1:1055 WELLINGTON WAY
Mailing Address - Street 2:SUITE 170
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1259
Mailing Address - Country:US
Mailing Address - Phone:859-554-5502
Mailing Address - Fax:859-554-5554
Practice Address - Street 1:1055 WELLINGTON WAY
Practice Address - Street 2:SUITE 170
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1259
Practice Address - Country:US
Practice Address - Phone:859-552-5502
Practice Address - Fax:859-552-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory