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General NPI Number Information
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NPI Number | 1063966745
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC LABORATORY SOLUTIONS
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 4225 OFFICE PKWY STE 104
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City | DALLAS
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State | TX
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Zip | 75204-3628
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Country | US
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Telephone | 949-467-9770
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Fax |
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Provider Business Mailing Address
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Address Line | 4225 OFFICE PKWY STE 104
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City | DALLAS
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State | TX
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Zip | 75204-3628
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Country | US
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Telephone | 949-467-9770
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH DEL SIGNORE
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Credential |
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Telephone | 949-467-9770
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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 | L21125456
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License Number State | AZ
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