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General NPI Number Information
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NPI Number | 1396419933
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Entity Type | Organization
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Legal Business Name | ATLANTIC LABS LLC
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Dates
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Enumeration Date | 08/06/2021
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 1329 W WALNUT HILL LN STE 116
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City | IRVING
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State | TX
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Zip | 75038-3270
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Country | US
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Telephone | 325-222-0621
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Fax | 346-521-3028
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Provider Business Mailing Address
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Address Line | PO BOX 143311
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City | IRVING
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State | TX
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Zip | 75014-3311
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Country | US
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Telephone | 325-222-0621
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Fax | 346-521-3028
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JENNIFER R KENNEDY
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Credential |
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Telephone | 325-222-0621
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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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