MEDICARE: IRVING DX LABORATORIES LLC

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
1	246RP1900X	Phlebotomy Technician
2	246RM2200X	Medical Laboratory Technician

General Provider Information

NPI Number	:	1386504058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRVING DX LABORATORIES LLC

Provider Business Mailing Address
First Line	:	3317 FINLEY RD STE 231
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-3200
Country	:	US
Telephone Number	:	224-470-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	3317 FINLEY RD STE 231
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-3200
Country	:	US
Telephone Number	:	224-470-9009
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MUJEEB AHMED MOHAMMED
Credential	:
Telephone Number	:	224-470-9009

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	12/12/2025

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Directions to “IRVING DX LABORATORIES LLC ” Practice Location

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