| NPI | 1376093187 |
|---|---|
| Former Legal Business Name | BEACH TOX, LLC |
| Entity Type | Organization |
| Authorized Contact | BRANT ALAN JOLLY Owner 424-396-0037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2021-01-20 |