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General NPI Number Information
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NPI Number | 1649459744
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS CLINICAL LABORATORY LTD
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 418 S 6TH ST
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City | KINGSVILLE
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State | TX
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Zip | 78363-5519
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Country | US
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Telephone | 361-516-1601
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Fax | 361-516-1633
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Provider Business Mailing Address
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Address Line | PO BOX 1162
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City | KINGSVILLE
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State | TX
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Zip | 78364-1162
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Country | US
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Telephone | 361-516-1601
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Fax | 361-516-1633
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Authorized Official
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Title or Position | PARTNER
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Name | ANDREW P. SANDERS
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Credential |
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Telephone | 361-516-1601
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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 | 45D1075228
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License Number State | TX
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