Provider Demographics
NPI:1851968226
Name:CONCIERGE TESTING SOLUTIONS, LLC.
Entity Type:Organization
Organization Name:CONCIERGE TESTING SOLUTIONS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-220-8279
Mailing Address - Street 1:4851 MEADOWBROOK PKWY UNIT 158
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3473
Mailing Address - Country:US
Mailing Address - Phone:816-645-3635
Mailing Address - Fax:
Practice Address - Street 1:1240 E MEYER BLVD STE 1240A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1206
Practice Address - Country:US
Practice Address - Phone:816-645-3635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-05
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCV2237OtherPRIMARY CLINIC STATE OF MISSOURI PROVIDER NUMBER