Provider Demographics
NPI:1811510027
Name:CLINICAL REFERENCE LABORATORY, INC.
Entity type:Organization
Organization Name:CLINICAL REFERENCE LABORATORY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF ACCOUNTING
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-693-5413
Mailing Address - Street 1:8433 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2802
Mailing Address - Country:US
Mailing Address - Phone:913-492-3652
Mailing Address - Fax:
Practice Address - Street 1:1121 W OLD HIGHWAY 56
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5256
Practice Address - Country:US
Practice Address - Phone:913-492-3652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICAL REFERENCE LABORATORY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory