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General NPI Number Information
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NPI Number | 1669287389
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Entity Type | Organization
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Legal Business Name | TEST TOX LLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1701 GREEN RD STE A6
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-1074
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Country | US
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Telephone | 833-403-4944
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Fax |
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Provider Business Mailing Address
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Address Line | 13681 NEWPORT AVE STE 8614
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City | TUSTIN
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State | CA
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Zip | 92780-4689
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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 | CEO
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Name | DAVID HAM
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Credential |
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Telephone | 657-218-9125
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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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