Provider Demographics
NPI:1467023499
Name:PCR-DX OF COLORADO, LLC
Entity type:Organization
Organization Name:PCR-DX OF COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-706-7727
Mailing Address - Street 1:2112 11TH AVE S STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2843
Mailing Address - Country:US
Mailing Address - Phone:205-882-5227
Mailing Address - Fax:205-588-0502
Practice Address - Street 1:2301 RESEARCH BLVD STE 201-202
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1825
Practice Address - Country:US
Practice Address - Phone:205-861-1951
Practice Address - Fax:855-871-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory