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General NPI Number Information
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NPI Number | 1124490313
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Entity Type | Organization
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Legal Business Name | CLARITY TOXICOLOGY, LLC
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 3204 LONG PRAIRIE RD SUITE A3
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City | FLOWER MOUND
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State | TX
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Zip | 75022-2718
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Country | US
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Telephone | 214-513-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 3204 LONG PRAIRIE RD SUITE A3
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City | FLOWER MOUND
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State | TX
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Zip | 75022-2718
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Country | US
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Telephone | 214-513-7878
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROB NEVILLE
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Credential |
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Telephone | 214-513-7878
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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 | 45D2084565
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License Number State | TX
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