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General NPI Number Information
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NPI Number | 1396668372
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Entity Type | Organization
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Legal Business Name | SOFT CELL L-FORM LABORATORIES LLC
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 4125 FAIRWAY DR STE 135
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City | CARROLLTON
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State | TX
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Zip | 75010-6510
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Country | US
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Telephone | 503-402-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 NE STUCKI AVE STE 100
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City | HILLSBORO
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State | OR
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Zip | 97006-6951
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Country | US
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Telephone | 503-402-2505
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ROEL CHAVEZ
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Credential |
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Telephone | 503-402-2505
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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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