Provider Demographics
NPI:1730645011
Name:MERCY LABS SOUTH LLC
Entity Type:Organization
Organization Name:MERCY LABS SOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP-REGIONAL LABORATORY SRVCS
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:POSINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-628-6390
Mailing Address - Street 1:645 MARYVILLE CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5855
Mailing Address - Country:US
Mailing Address - Phone:314-628-3690
Mailing Address - Fax:
Practice Address - Street 1:10010 KENNERLY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2106
Practice Address - Country:US
Practice Address - Phone:314-525-4034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory