Provider Demographics
NPI:1205514791
Name:COMMONWEALTH TESTING
Entity type:Organization
Organization Name:COMMONWEALTH TESTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-236-6002
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40468-0404
Mailing Address - Country:US
Mailing Address - Phone:859-236-6002
Mailing Address - Fax:859-236-9001
Practice Address - Street 1:380 WHIRLAWAY DR STE 1
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-9561
Practice Address - Country:US
Practice Address - Phone:859-236-6002
Practice Address - Fax:859-236-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory