Provider Demographics
NPI:1578806576
Name:PINNACLE LABORATORIES, LLC
Entity Type:Organization
Organization Name:PINNACLE LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BEALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-494-8003
Mailing Address - Street 1:2375 PROFESSIONAL HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3040
Mailing Address - Country:US
Mailing Address - Phone:859-554-5181
Mailing Address - Fax:
Practice Address - Street 1:2375 PROFESSIONAL HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3040
Practice Address - Country:US
Practice Address - Phone:859-554-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29531291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory