Organization
INFLAMMATORY MARKERS DIAGNOSTIC LABORATORY LLC
Active
Other names
INFLAMMATORY MARKERS LABORATORY, INFLAMMATORY MARKERS LAB
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES T HINSHAW MD (LAB DIRECTOR)
(316) 558-5850
Entity
Organization
Contact information
Practice address
9412 E CENTRAL AVE, WICHITA, KS 67206-2540
(316) 558-5850
(888) 494-1636
Mailing address
9412 E CENTRAL AVE, WICHITA, KS 67206-2540
(316) 558-5850
(316) 558-5789
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17D2145407
CLIA CERTIFICATE OF COMPLIANCE
KS
Enumeration date
04/07/2021
Last updated
01/25/2023
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