Provider Demographics
NPI:1124276688
Name:ROCKY MOUNTAIN FERTILITY LAB
Entity type:Organization
Organization Name:ROCKY MOUNTAIN FERTILITY LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-999-3877
Mailing Address - Street 1:12770 LYNNFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4128
Mailing Address - Country:US
Mailing Address - Phone:303-999-3877
Mailing Address - Fax:303-999-3878
Practice Address - Street 1:12770 LYNNFIELD DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-4128
Practice Address - Country:US
Practice Address - Phone:303-999-3877
Practice Address - Fax:303-999-3878
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO REPRODUCTIVE ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-08
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory