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General NPI Number Information
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NPI Number | 1073776860
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Entity Type | Organization
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Legal Business Name | MICROGENDX, LLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 6901 QUAKER AVE STE 200
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City | LUBBOCK
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State | TX
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Zip | 79413-5940
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Country | US
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Telephone | 806-776-2611
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Fax | 806-749-7886
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Provider Business Mailing Address
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Address Line | 5776 HOFFNER AVE STE 203
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City | ORLANDO
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State | FL
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Zip | 32822-4810
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Country | US
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Telephone | 806-776-2611
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Fax | 806-749-7886
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SHANLEY COLLINS
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Credential |
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Telephone | 806-776-2611
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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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