Provider Demographics
NPI:1497235816
Name:KAMA LAB TECH, INC
Entity type:Organization
Organization Name:KAMA LAB TECH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-308-2063
Mailing Address - Street 1:311 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2446
Mailing Address - Country:US
Mailing Address - Phone:651-888-6800
Mailing Address - Fax:651-888-6839
Practice Address - Street 1:311 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2446
Practice Address - Country:US
Practice Address - Phone:651-888-6800
Practice Address - Fax:651-888-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory