Healthcare Provider Details

I. General information

NPI: 1306800958
Provider Name (Legal Business Name): RICHARDS LABORATORIES OF TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5703 WESTCREEK DR SUITE A
FORT WORTH TX
76133-3301
US

IV. Provider business mailing address

55 E CENTER ST
PLEASANT GROVE UT
84062-2233
US

V. Phone/Fax

Practice location:
  • Phone: 817-370-1244
  • Fax: 817-294-8065
Mailing address:
  • Phone: 801-785-2500
  • Fax: 801-785-2521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateTX

VIII. Authorized Official

Name: MRS. ANN LEE RICHARDS
Title or Position: PRESIDENT
Credential:
Phone: 801-785-2500