Provider Demographics
NPI:1891162665
Name:TRINITY CLINICAL LABORATORIES, LLC
Entity type:Organization
Organization Name:TRINITY CLINICAL LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-372-0082
Mailing Address - Street 1:751 HEBRON PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-5002
Mailing Address - Country:US
Mailing Address - Phone:972-315-5013
Mailing Address - Fax:972-315-5033
Practice Address - Street 1:751 HEBRON PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-5055
Practice Address - Country:US
Practice Address - Phone:972-315-5013
Practice Address - Fax:972-315-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory