Provider Demographics
NPI:1598836678
Name:WCP LABORATORIES, INC
Entity Type:Organization
Organization Name:WCP LABORATORIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-991-4313
Mailing Address - Street 1:2326 MILLPARK DR
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-3530
Mailing Address - Country:US
Mailing Address - Phone:314-991-4313
Mailing Address - Fax:314-991-4317
Practice Address - Street 1:2326 MILLPARK DR
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-3530
Practice Address - Country:US
Practice Address - Phone:314-991-4313
Practice Address - Fax:314-991-4317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO14D0913186291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO131223OtherHEALTHLINK
MO000012921OtherMEDICARE PTAN
MO26847OtherGROUP HEALTH PLAN
MO113515OtherBLUE CROSS BLUE SHIELD
MO708658307Medicaid