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General NPI Number Information
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NPI Number | 1326482910
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Entity Type | Organization
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Legal Business Name | OBX LABORATORIES, LLC
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 07/20/2017
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Provider Practice Location Address
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Address Line | 1313 VALWOOD PKWY SUITE 240
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City | CARROLLTON
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State | TX
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Zip | 75006
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Country | US
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Telephone | 940-220-7496
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Fax | 866-731-1999
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Provider Business Mailing Address
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Address Line | 1313 VALWOOD PKWY SUITE 240
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City | CARROLLTON
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State | TX
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Zip | 75006
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Country | US
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Telephone | 940-220-7496
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Fax | 866-731-1999
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER/PRINCIPAL
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Name | LYNN FOSSUM
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Credential |
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Telephone | 888-644-0030
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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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