MEDICARE: SM LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	45D0882276	TX

General Provider Information

NPI Number	:	1043677396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SM LABS LLC

Provider Business Mailing Address
First Line	:	5700 GRANITE PKWY
Second Line	:	SUITE 234
City	:	PLANO
State	:	TX
Zip	:	75024-6622
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 GRANITE PARKWAY
Second Line	:	SUITE 234
City	:	PLANO
State	:	TX
Zip	:	75024-6602
Country	:	US
Telephone Number	:	972-349-0014
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	PATRICK LYNN
Credential	:
Telephone Number	:	972-349-0014

Provider Enumeration Date	:	01/18/2016
Last Update Date	:	03/21/2016

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Directions to “SM LABS LLC ” Practice Location

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