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General NPI Number Information
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NPI Number | 1306165030
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Entity Type | Organization
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Legal Business Name | STRATEGIC LABORATORY SERVICES, LLC
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 2029 E LEVEE ST
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City | DALLAS
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State | TX
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Zip | 75207
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Country | US
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Telephone | 512-809-7277
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Fax |
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Provider Business Mailing Address
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Address Line | 2029 E LEVEE ST
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City | DALLAS
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State | TX
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Zip | 75207-6703
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Country | US
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Telephone | 512-809-7277
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS JOHN GILLILAND
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Credential |
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Telephone | 214-440-1444
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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 | 45D1085290
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License Number State | TX
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