| NPI | 1457002933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA TANYE EDWARDS Lab Director 972-209-6437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 261Q00000X |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2022-01-15 |
| Last Update Date | 2023-06-06 |