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General NPI Number Information
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NPI Number | 1013255793
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Entity Type | Organization
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Legal Business Name | CONSOLIDATED LABORATORIES
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 2810 W CHARLESTON BLVD F53
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City | LAS VEGAS
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State | NV
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Zip | 89102-1921
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Country | US
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Telephone | 702-696-1555
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Fax | 702-737-0493
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Provider Business Mailing Address
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Address Line | 2595 S CIMARRON RD SUITE 105
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City | LAS VEGAS
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State | NV
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Zip | 89117-7613
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Country | US
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Telephone | 702-233-1791
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Fax | 702-737-0493
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL STRICKLAND
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Credential |
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Telephone | 702-696-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | NV
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