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General NPI Number Information
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NPI Number | 1891547790
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Entity Type | Organization
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Legal Business Name | TCF LAB SERVICE LLC
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 6815 MANHATTAN BLVD STE 105
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City | FORT WORTH
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State | TX
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Zip | 76120-1212
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Country | US
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Telephone | 936-221-1099
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Fax | 936-221-1099
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Provider Business Mailing Address
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Address Line | 6815 MANHATTAN BLVD STE 105
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City | FORT WORTH
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State | TX
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Zip | 76120-1212
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Country | US
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Telephone | 936-221-1099
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Fax | 469-281-1982
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MS. EVELINA L KISSENTANER
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Credential |
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Telephone | 682-282-7513
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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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