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General NPI Number Information
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NPI Number | 1518483544
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Entity Type | Organization
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Legal Business Name | NEXT GENERATION LABS LLC
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 08/22/2017
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Provider Practice Location Address
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Address Line | 611 N MACARTHUR BLVD
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City | IRVING
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State | TX
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Zip | 75061-7428
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Country | US
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Telephone | 972-254-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 4047 OKEECHOBEE BLVD STE 217
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-3237
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Country | US
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Telephone | 561-833-9960
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Fax | 561-835-1201
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Authorized Official
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Title or Position | MANGER
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Name | KENNETH STEPHEN METZLER II
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Credential | RPT
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Telephone | 561-833-9960
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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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