Provider Demographics
NPI:1144462524
Name:REGIONAL LABORATORY ALLIANCE LLC C/O PHYSICIANS REFERENCE LABORATORY
Entity type:Organization
Organization Name:REGIONAL LABORATORY ALLIANCE LLC C/O PHYSICIANS REFERENCE LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ORNER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MT (ASCP)
Authorized Official - Phone:913-831-2098
Mailing Address - Street 1:4401 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3220
Mailing Address - Country:US
Mailing Address - Phone:816-932-3704
Mailing Address - Fax:816-932-9618
Practice Address - Street 1:4401 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3220
Practice Address - Country:US
Practice Address - Phone:816-932-3704
Practice Address - Fax:816-932-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory