Provider Demographics
NPI:1952777831
Name:QUASAR ANALYTICAL LABORATORIES, LLC
Entity Type:Organization
Organization Name:QUASAR ANALYTICAL LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:KEPHART
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-418-5210
Mailing Address - Street 1:4419 CENTENNIAL BLVD
Mailing Address - Street 2:PMB STE 250
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3739
Mailing Address - Country:US
Mailing Address - Phone:719-309-6270
Mailing Address - Fax:719-574-2404
Practice Address - Street 1:4835 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3308
Practice Address - Country:US
Practice Address - Phone:719-309-6270
Practice Address - Fax:719-574-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06D2108666291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory