# PHYSICIANS REFERENCE LABORATORY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881609600
- **Authorized official:** MR. GREGORY J KEITGES (COO)
- **Authorized official phone:** (913) 338-4070

## Contact information

- **Practice address:** 1600 N 2ND ST, CLINTON, MO 64735-1192
- **Practice address phone:** (913) 338-4070
- **Practice address fax:** (913) 338-4245
- **Mailing address:** 7800 W 110TH ST, STE 200, OVERLAND PARK, KS 66210-2304
- **Mailing address phone:** (913) 338-4070
- **Mailing address fax:** (913) 338-4245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZB0001X | Blood Banking & Transfusion Medicine Physician | — | NULL | — |
| 207ZB0001X | Blood Banking & Transfusion Medicine Physician | — | — | — |
| 207ZC0500X | Cytopathology Physician | — | NULL | — |
| 207ZC0500X | Cytopathology Physician | — | — | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | NULL | — |
| 207ZD0900X | Dermatopathology (Pathology) Physician | — | — | — |
| 207ZN0500X | Neuropathology Physician | — | NULL | — |
| 207ZN0500X | Neuropathology 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 | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 07/31/2012