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General NPI Number Information
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NPI Number | 1891162665
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Entity Type | Organization
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Legal Business Name | TRINITY CLINICAL LABORATORIES, LLC
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 751 HEBRON PKWY SUITE 110
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City | LEWISVILLE
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State | TX
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Zip | 75057-5055
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Country | US
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Telephone | 972-315-5013
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Fax | 972-315-5033
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Provider Business Mailing Address
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Address Line | 751 HEBRON PKWY STE 110
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City | LEWISVILLE
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State | TX
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Zip | 75057-5002
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Country | US
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Telephone | 972-315-5013
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Fax | 972-315-5033
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN GRISHAM
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Credential |
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Telephone | 940-372-0082
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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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