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General NPI Number Information
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NPI Number | 1841079670
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Entity Type | Organization
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Legal Business Name | CAR GENETICS & MOLECULAR DIAGNOSTICS LAB
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 3024 E WOODSON LATERAL RD
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City | HENSLEY
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State | AR
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Zip | 72065-9169
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Country | US
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Telephone | 870-534-2900
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Fax | 870-534-9726
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Provider Business Mailing Address
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Address Line | 3024 E WOODSON LATERAL RD
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City | HENSLEY
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State | AR
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Zip | 72065-9169
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Country | US
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Telephone | 870-534-2900
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Fax | 870-534-9726
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Authorized Official
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Title or Position | OWNER
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Name | MISHA MAHMOOD
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Credential |
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Telephone | 870-534-2900
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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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