Healthcare Provider Details

I. General information

NPI: 1871240119
Provider Name (Legal Business Name): DALYKA LABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20810 GULF FWY STE F
WEBSTER TX
77598-6421
US

IV. Provider business mailing address

20810 GULF FWY STE F
WEBSTER TX
77598-6421
US

V. Phone/Fax

Practice location:
  • Phone: 917-697-1135
  • Fax:
Mailing address:
  • Phone: 917-697-1135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TOMMY MAOZ
Title or Position: CEO
Credential: MD
Phone: 917-697-1135