Provider Demographics
NPI:1386133650
Name:RENO LIQUID LLC
Entity type:Organization
Organization Name:RENO LIQUID LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MCKAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-228-2826
Mailing Address - Street 1:14825 KIVETT LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8317
Mailing Address - Country:US
Mailing Address - Phone:805-228-2826
Mailing Address - Fax:
Practice Address - Street 1:14825 KIVETT LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8317
Practice Address - Country:US
Practice Address - Phone:805-228-2826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENO LIQUID LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9740291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory