Provider Demographics
NPI:1063976835
Name:EXPRESS TECH, LLC
Entity type:Organization
Organization Name:EXPRESS TECH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CORWYN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MAJORS
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:800-400-4118
Mailing Address - Street 1:PO BOX 8292
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91224-0292
Mailing Address - Country:US
Mailing Address - Phone:800-400-4118
Mailing Address - Fax:877-400-9284
Practice Address - Street 1:7354 VALAHO LN
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2639
Practice Address - Country:US
Practice Address - Phone:800-400-4118
Practice Address - Fax:877-400-9284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty