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General NPI Number Information
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NPI Number | 1669088159
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Entity Type | Organization
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Legal Business Name | NM LABORATORY SERVICES LLC
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Dates
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Enumeration Date | 09/20/2020
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Last Update Date | 09/20/2020
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Provider Practice Location Address
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Address Line | 7109 W LOOP 1604 N LOT 137
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City | SAN ANTONIO
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State | TX
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Zip | 78254-9557
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Country | US
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Telephone | 513-978-7247
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Fax |
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Provider Business Mailing Address
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Address Line | 7109 W LOOP 1604 N LOT 137
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City | SAN ANTONIO
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State | TX
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Zip | 78254-9557
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Country | US
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Telephone | 513-978-7247
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIKITA MOODIE
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Credential |
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Telephone | 513-978-7247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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