Organization
SPECTRA LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX RYDER MD (SENIOR VP AND MEDICAL DIRECTOR)
(877) 334-0021
Entity
Organization
Contact information
Practice address
1280 STATELINE RD E, SOUTHAVEN, MS 38671-9486
(877) 334-0021
(800) 716-5539
Mailing address
1280 STATELINE RD E, SOUTHAVEN, MS 38671-9486
(877) 334-0021
(800) 716-5539
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003263868A
—
GA
05
—
013403892
—
DC
05
—
0468700
—
OH
05
—
08652003
—
MS
05
—
100245690C
—
KS
05
—
10026890900
—
NE
05
—
103860
—
AZ
05
—
112006800
—
FL
05
—
1396321022
—
AK
05
—
1396321022
—
AL
05
—
1396321022
—
CA
05
—
1396321022
—
CT
05
—
1396321022
—
HI
05
—
1396321022
—
IA
05
—
1396321022
—
ID
05
—
1396321022
—
IL
05
—
1396321022
—
ME
05
—
1396321022
—
MI
05
—
1396321022
—
MN
05
—
1396321022
—
MT
05
—
1396321022
—
NC
05
—
1396321022
—
SD
05
—
1396321022
—
WI
05
—
1396321022
—
WV
05
—
209158500
—
WY
05
—
2203364
—
WA
05
—
2574035
—
LA
05
—
273863709
—
AR
05
—
4092925
—
UT
05
—
440392501
—
TX
05
—
649049-OC
—
AS
05
—
6709267
—
VT
05
—
700104418
—
MO
05
—
7100777440
—
KY
05
—
9000198819
—
CO
05
—
97820288
—
NM
05
—
GBB
—
GU
05
—
L00865
—
SC
05
—
Q069018
—
TN
Enumeration date
03/23/2021
Last updated
06/25/2025
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