Organization
BOYCE - BYNUM PATHOLOGY LABORATORIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD E COTTEN (CHIEF OPERATING OFFICER)
(573) 886-4600
Entity
Organization
Contact information
Practice address
200 PORTLAND ST, COLUMBIA, MO 65201
(573) 886-4600
(573) 886-4695
Mailing address
200 PORTLAND ST, COLUMBIA, MO 65201-6525
(573) 886-4600
(573) 886-4695
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
26D0652373
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100455390B
—
KS
01
—
120064
BLUE CROSS BLUE SHIELD
—
05
—
126758709
—
AR
05
—
20030120A
—
OK
05
—
2194119
—
LA
05
—
275331
—
OH
05
—
300000488
—
IN
05
—
36079966
—
IL
05
—
6593789800
—
KY
01
—
700595812
MISSOURI CARE
—
05
—
700595812
—
MO
05
—
8156825
—
MS
01
—
888497
MERCY CAREPLUS
—
Enumeration date
03/23/2006
Last updated
06/20/2018
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