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General NPI Number Information
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NPI Number | 1679075097
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Entity Type | Organization
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Legal Business Name | DESERT TOX SERVICES, LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 18862 N 77TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-5955
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Country | US
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Telephone | 310-503-9177
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Fax | 928-255-4817
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Provider Business Mailing Address
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Address Line | 18862 N 77TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-5955
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Country | US
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Telephone | 310-503-9177
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Fax | 928-255-4817
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Authorized Official
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Title or Position | OWNER
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Name | FRANK AFFINITO
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Credential |
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Telephone | 310-503-9177
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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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