MEDICARE: CENTRAL TOX, 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	45D2082145	TX

General Provider Information

NPI Number	:	1710394978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL TOX, LLC

Provider Business Mailing Address
First Line	:	525 ROUND ROCK WEST DR STE B240
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5020
Country	:	US
Telephone Number	:	512-382-9710
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 ROUND ROCK WEST DR STE B240
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5020
Country	:	US
Telephone Number	:	512-382-9710
Fax Number	:

Authorized Official
Title or Position	:	LAB MANAGER
Name	:	MEAGAN AGUIRRE
Credential	:
Telephone Number	:	512-382-9710

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	04/24/2020

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