Provider Demographics
NPI:1891805958
Name:REGIONAL LABORATORY CONSULTANTS PC
Entity Type:Organization
Organization Name:REGIONAL LABORATORY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DENKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-241-8861
Mailing Address - Street 1:1212 PLEASANT ST
Mailing Address - Street 2:SUITE LL3
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1414
Mailing Address - Country:US
Mailing Address - Phone:515-241-8866
Mailing Address - Fax:515-241-8855
Practice Address - Street 1:1200 PLEASANT
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1414
Practice Address - Country:US
Practice Address - Phone:515-241-8866
Practice Address - Fax:515-241-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2119586Medicaid
IA2119586Medicaid