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General NPI Number Information
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NPI Number | 1053841023
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Entity Type | Organization
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Legal Business Name | QUALITY FORENSIC TOXICOLOGY LLC
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 4726 SHAVANO OAK STE 105
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4029
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Country | US
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Telephone | 210-463-9191
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Fax | 210-463-9190
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Provider Business Mailing Address
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Address Line | 4726 SHAVANO OAK STE 105
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4029
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Country | US
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Telephone | 210-463-9191
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Fax | 210-463-9190
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Authorized Official
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Title or Position | CFO/COO
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Name | MRS. REGINA L TRIPP
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Credential |
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Telephone | 210-463-9191
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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 |
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