Provider Demographics
NPI:1538860119
Name:EMPIRE CENTRAL LABORATORY LLC
Entity type:Organization
Organization Name:EMPIRE CENTRAL LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-675-4774
Mailing Address - Street 1:1451 EMPIRE CENTRAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4063
Mailing Address - Country:US
Mailing Address - Phone:214-675-4774
Mailing Address - Fax:214-580-2630
Practice Address - Street 1:1451 EMPIRE CENTRAL DR STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4063
Practice Address - Country:US
Practice Address - Phone:214-675-4774
Practice Address - Fax:214-580-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
No293D00000XLaboratoriesPhysiological Laboratory