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Organization
PHYSICIANS REFERENCE LABORATORY LLC
Active
Organization
PHYSICIANS REFERENCE LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY J KEITGES (COO)
(913) 338-4070
Entity
Organization
Contact information
Practice address
203 NW R D MIZE RD, STE 218, BLUE SPRINGS, MO 64014-2510
(913) 338-4070
(913) 338-4245
Mailing address
7800 W 110TH ST, OVERLAND PARK, KS 66210-2304
(913) 338-4070
(913) 338-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
—
NULL
207ZC0006X
Clinical Pathology Physician
—
—
207ZC0500X
Cytopathology Physician
—
NULL
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
NULL
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
NULL
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
NULL
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
NULL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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