Provider Demographics
NPI:1477658516
Name:REPRODUCTIVE LABORATORY INC
Entity Type:Organization
Organization Name:REPRODUCTIVE LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HANNA
Authorized Official - Last Name:KUTTEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, HCLD
Authorized Official - Phone:901-747-2229
Mailing Address - Street 1:9250 GLENDA RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-6702
Mailing Address - Country:US
Mailing Address - Phone:901-747-2229
Mailing Address - Fax:901-747-4446
Practice Address - Street 1:80 HUMPHREYS CTR
Practice Address - Street 2:SUITE 307
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2353
Practice Address - Country:US
Practice Address - Phone:901-747-2229
Practice Address - Fax:901-747-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory