Organization
VERRALAB JA LLC
Active
Other names
BioTap Medical
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN REYNOLDS PHD (PRESIDENT)
(502) 566-3588
Entity
Organization
Contact information
Practice address
716 W MAIN ST STE 100A, LOUISVILLE, KY 40202-2777
(502) 566-3588
(502) 561-0089
Mailing address
716 W MAIN ST STE 100A, LOUISVILLE, KY 40202-2777
(502) 566-3588
(502) 566-0089
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003162261A
—
GA
05
—
01370700
—
MS
05
—
0145798
—
OH
05
—
016955600
—
FL
05
—
1533914
—
TN
05
—
180323
—
AL
05
—
180852
—
AL
05
—
1821360017
—
MO
05
—
1821360017
—
WV
05
—
201127880A
—
KS
05
—
201184500A
—
IN
05
—
210097709
—
AR
05
—
22029532
—
NM
05
—
3255051
—
TX
05
—
7100223830
—
KY
05
—
922818
—
AZ
05
—
L00443
—
SC
Enumeration date
02/02/2012
Last updated
03/28/2022
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