Provider Demographics
NPI:1851649578
Name:QUICK DRAW LABORATORY, LLC
Entity Type:Organization
Organization Name:QUICK DRAW LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WIGGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-436-4206
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-0166
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 HICKORY STREET
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-0166
Practice Address - Country:US
Practice Address - Phone:573-436-4206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory