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General NPI Number Information
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NPI Number | 1164019725
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Entity Type | Organization
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Legal Business Name | DNA ANALYTICAL LABORATORY LV LLC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 4310 CAMERON ST STE 9
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City | LAS VEGAS
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State | NV
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Zip | 89103-3826
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Country | US
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Telephone | 702-550-0124
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Fax | 702-675-8122
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Provider Business Mailing Address
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Address Line | 4310 CAMERON ST STE 9
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City | LAS VEGAS
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State | NV
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Zip | 89103-3826
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Country | US
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Telephone | 702-550-0124
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Fax | 702-675-8122
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Authorized Official
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Title or Position | DIRECTOR OF LABORATORY OPERATIONS
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Name | MR. LISA KAPLAN
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Credential |
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Telephone | 469-230-7545
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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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