Provider Demographics
NPI:1396817466
Name:CYTOCHECK LABORATORY, LLC
Entity Type:Organization
Organization Name:CYTOCHECK LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-421-2424
Mailing Address - Street 1:1902 S US HIGHWAY 59
Mailing Address - Street 2:BUILDING D
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-4948
Mailing Address - Country:US
Mailing Address - Phone:620-423-1555
Mailing Address - Fax:620-423-3913
Practice Address - Street 1:5200 S YALE AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7451
Practice Address - Country:US
Practice Address - Phone:620-423-1555
Practice Address - Fax:620-423-3913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CYTOCHECK LABORATORY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-14
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00018279OtherRAILROAD MEDICARE
OKP00018279OtherRAILROAD MEDICARE
OKP00018279Medicare PIN