Provider Demographics
NPI:1194474106
Name:US DIAGNOSTIC LABS
Entity type:Organization
Organization Name:US DIAGNOSTIC LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PUNIT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:184-487-5227
Mailing Address - Street 1:328 W MAIN ST STE 11
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-2900
Mailing Address - Country:US
Mailing Address - Phone:844-875-2270
Mailing Address - Fax:844-875-2270
Practice Address - Street 1:328 W MAIN ST STE 11
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-2900
Practice Address - Country:US
Practice Address - Phone:844-875-2270
Practice Address - Fax:844-875-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory