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General NPI Number Information
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NPI Number | 1265839963
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Entity Type | Organization
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Legal Business Name | QUICKLABS USA LLC
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Dates
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Enumeration Date | 11/24/2014
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Last Update Date | 05/08/2015
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Provider Practice Location Address
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Address Line | 611 N MACARTHUR BLVD STE 115
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City | IRVING
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State | TX
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Zip | 75061-7423
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Country | US
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Telephone | 972-254-1777
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Fax | 972-254-2111
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Provider Business Mailing Address
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Address Line | 611 N MACARTHUR BLVD STE 115
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City | IRVING
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State | TX
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Zip | 75061-7423
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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 | PRESIDENT
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Name | DURGA VEDATI
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Credential |
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Telephone | 972-254-1777
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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 | 45D2093064
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License Number State | TX
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