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General NPI Number Information
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NPI Number | 1144671223
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Entity Type | Organization
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Legal Business Name | ABS LABS LLC
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 2404 ARBUCKLE CT
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City | DALLAS
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State | TX
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Zip | 75229-4506
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Country | US
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Telephone | 214-364-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 WALLACE DR SUITE 100
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City | CARROLLTON
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State | TX
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Zip | 75006-8006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED PERSON
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Name | JARED ROCHWERG
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Credential |
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Telephone | 917-817-6482
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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 | 21975
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License Number State |
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