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General NPI Number Information
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NPI Number | 1568799591
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Entity Type | Organization
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Legal Business Name | CENTRAL LABORATORY SERVICES, INC.
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 703 MCKINNEY AVE STE. 403
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City | DALLAS
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State | TX
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Zip | 75202-1007
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Country | US
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Telephone | 469-364-3752
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Fax |
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Provider Business Mailing Address
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Address Line | 703 MCKINNEY AVE STE. 403
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City | DALLAS
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State | TX
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Zip | 75202-1007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF LABORATORY SERVICES
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Name | CHARLOTTE VDOVYCHENCKO
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Credential |
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Telephone | 817-915-1800
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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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