Organization
PHYSICIANS REFERENCE LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY J KEITGES (COO)
(913) 338-4070
Entity
Organization
Contact information
Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(913) 338-4070
(913) 338-4245
Mailing address
7800 W 110TH ST, STE 200, OVERLAND PARK, KS 66210-2304
(913) 338-4070
(913) 338-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZN0500X
Neuropathology Physician
—
—
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD5377
RAILROAD MEDICARE
MO
Enumeration date
08/01/2006
Last updated
07/31/2012
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