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NPI Code Detail

MEDICARE: SONIC REFERENCE LABORATORY, INC

MEDICARE: SONIC REFERENCE LABORATORY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory
2291U00000XClinical Medical Laboratory45D2083658TX

General Provider Information

NPI Number : 1174925440
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONIC REFERENCE LABORATORY, INC
Provider Business Mailing Address
First Line : 3800 QUICK HILL ROAD
Second Line : BLDG 3, SUITE 101
City : AUSTIN
State : TX
Zip : 78728-1342
Country : US
Telephone Number : 512-531-2100
Fax Number : 512-531-2203
Provider Business Practice Location Address
First Line : 3800 QUICK HILL ROAD
Second Line : BLDG 3, SUITE 101
City : AUSTIN
State : TX
Zip : 78728-1342
Country : US
Telephone Number : 512-531-2100
Fax Number : 512-531-2203
Authorized Official
Title or Position : PRESIDENT
Name : ANTHONY CARTER
Credential : PHD
Telephone Number : 512-873-1670
Provider Enumeration Date : 09/18/2014
Last Update Date : 04/02/2022

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Directions to “SONIC REFERENCE LABORATORY, INC ” Practice Location

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