Provider Demographics
NPI:1831714542
Name:VIRA TESTED LLC
Entity type:Organization
Organization Name:VIRA TESTED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELEMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-746-8950
Mailing Address - Street 1:8801 SPRING CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-7696
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8801 SPRING CREEK TRL
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-7696
Practice Address - Country:US
Practice Address - Phone:720-746-8950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No251K00000XAgenciesPublic Health or Welfare