Provider Demographics
NPI:1487932364
Name:COREMEDICA LABORATORIES INC
Entity type:Organization
Organization Name:COREMEDICA LABORATORIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZUEHLSDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-600-2535
Mailing Address - Street 1:200 NE MISSOURI RD
Mailing Address - Street 2:SUITE 258
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-4722
Mailing Address - Country:US
Mailing Address - Phone:877-449-7942
Mailing Address - Fax:866-299-5762
Practice Address - Street 1:200 NE MISSOURI RD
Practice Address - Street 2:SUITE 258
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4722
Practice Address - Country:US
Practice Address - Phone:877-449-7942
Practice Address - Fax:866-299-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory