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General NPI Number Information
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NPI Number | 1760760805
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Entity Type | Organization
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Legal Business Name | TEXAS STATE CLINICAL LABORATORIES, INC
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 11149 RESEARCH BLVD STE 360
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City | AUSTIN
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State | TX
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Zip | 78759-5279
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Country | US
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Telephone | 512-346-5600
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Fax | 512-241-1554
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Provider Business Mailing Address
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Address Line | 11149 RESEARCH BLVD STE 360
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City | AUSTIN
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State | TX
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Zip | 78759-5279
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Country | US
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Telephone | 512-346-5600
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Fax | 512-241-1554
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. TIMOTHY B ROBERSON
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Credential | PA.
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Telephone | 903-372-1010
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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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