Provider Demographics
NPI:1952962425
Name:COASTAL LABS OF COLORADO LLC
Entity Type:Organization
Organization Name:COASTAL LABS OF COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHINDEHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-419-1583
Mailing Address - Street 1:1449 W LITTLETON BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2127
Mailing Address - Country:US
Mailing Address - Phone:303-419-1583
Mailing Address - Fax:
Practice Address - Street 1:1449 W LITTLETON BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2127
Practice Address - Country:US
Practice Address - Phone:303-419-1583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory