Organization
KBN DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE MANGORNCHAI (MANAGER)
(913) 451-0059
Entity
Organization
Contact information
Practice address
6345 LONG AVE STE 101, SHAWNEE, KS 66216-2577
(913) 914-1404
Mailing address
PO BOX 27311, OVERLAND PARK, KS 66225-7311
(913) 451-0059
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17D2183723
CLIA
KS
Enumeration date
12/10/2020
Last updated
12/10/2020
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