Organization
PATHLAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. W LEWIS RANDALL MD (PRESIDENT)
(620) 225-2522
Entity
Organization
Contact information
Practice address
705 1ST AVE, SUITE A, DODGE CITY, KS 67801-4437
(620) 225-2522
Mailing address
PO BOX 1453, DODGE CITY, KS 67801-1453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
08/20/2006
Last updated
08/22/2020
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