Provider Demographics
NPI:1427776780
Name:ROCKY MOUNTAIN LABORATORIES LLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN LABORATORIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-800-1123
Mailing Address - Street 1:12217 S LONE PEAK PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9465
Mailing Address - Country:US
Mailing Address - Phone:385-800-1123
Mailing Address - Fax:
Practice Address - Street 1:1411 S POTOMAC ST STE 330
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4539
Practice Address - Country:US
Practice Address - Phone:833-765-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN LABORATORIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-22
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory