NPI Provider: 1497001234
Contact Name: JOHNSON ROBIN
Position: LABORATORY DIRECTOR
Phone: (512) 906-5507
Stat Lab Information:
Stat Lab organization have npi 1497001234, taxonomy code is 291U00000X with license number is 45D2043244 in . This Business address located in 1515 KELLETT AVE, SCHULENBURG, TX 78956 Texas.
Practice Location
Address: 7901 CAMERON RD, AUSTIN, TX 78754
Phone: (512) 906-5507
Business Location
Address: 1515 KELLETT AVE, SCHULENBURG, TX 78956
Phone: (512) 906-5507
Fax: (512) 973-8288
Taxonomy
Taxonomy Code: 291U00000X
License Number: 45D2043244
License Number of State: TX
Primary Taxonomy Switch: Y
Enumeration Date: 07/30/2012
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