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General NPI Number Information
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NPI Number | 1699626036
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Entity Type | Organization
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Legal Business Name | ID LABS LLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 7859 WALNUT HILL LN STE 320
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City | DALLAS
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State | TX
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Zip | 75230-5635
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Country | US
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Telephone | 480-674-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 14500 N NORTHSIGHT BLVD STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3659
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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 | OWNER
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Name | NICK GLIMCHER
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Credential |
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Telephone | 480-674-6565
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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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