Provider Demographics
NPI:1619680675
Name:RCL GENOMICS CLINICAL LABORATORIES, LLC
Entity Type:Organization
Organization Name:RCL GENOMICS CLINICAL LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-309-4720
Mailing Address - Street 1:10800 E BETHANY DR STE 301
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2687
Mailing Address - Country:US
Mailing Address - Phone:720-492-1023
Mailing Address - Fax:720-492-1033
Practice Address - Street 1:10800 E BETHANY DR STE 301
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2687
Practice Address - Country:US
Practice Address - Phone:720-492-1023
Practice Address - Fax:720-492-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory