Healthcare Provider Details

I. General information

NPI: 1124327622
Provider Name (Legal Business Name): COMPLIANCE TOXICOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 GIBBS ST
NEW WAVERLY TX
77358-3642
US

IV. Provider business mailing address

25810 OAK RIDGE DR
SPRING TX
77380-2016
US

V. Phone/Fax

Practice location:
  • Phone: 936-321-0214
  • Fax: 281-364-9642
Mailing address:
  • Phone: 281-419-9669
  • Fax: 281-364-9642

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: DR. SAMUEL ALIANELL
Title or Position: GENERAL MANAGER
Credential: M.D.
Phone: 936-321-0214