Provider Demographics
NPI:1487439022
Name:SHOW-ME DIAGNOSTIC LAB, LLC
Entity type:Organization
Organization Name:SHOW-ME DIAGNOSTIC LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPT,CPC
Authorized Official - Phone:417-440-1471
Mailing Address - Street 1:104 E PARK AVE STE 128
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:MO
Mailing Address - Zip Code:64485-1956
Mailing Address - Country:US
Mailing Address - Phone:816-261-4911
Mailing Address - Fax:
Practice Address - Street 1:104 E PARK AVE STE 128
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:MO
Practice Address - Zip Code:64485-1956
Practice Address - Country:US
Practice Address - Phone:816-261-4911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty