Provider Demographics
NPI:1710188917
Name:PGS LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:PGS LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:S
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-219-2820
Mailing Address - Street 1:PO BOX 23823
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40523-3823
Mailing Address - Country:US
Mailing Address - Phone:859-219-2820
Mailing Address - Fax:
Practice Address - Street 1:1055 WELLINGTON WAY
Practice Address - Street 2:SUITE 170
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1259
Practice Address - Country:US
Practice Address - Phone:859-219-2820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory