East Texas Clinical Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EAST TEXAS CLINICAL LABORATORY LLC

Practice address

9301 North Central Expressway
Tower 2 Suite 335a
Dallas, TX 75231

Phone

(972) 630-6400

NPI assigned

Jul 10, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dean Viskovich

Title

VP of Compliance

Phone

(972) 630-6400

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1407111024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 NORTH CENTRAL EXPRESSWAY",
            "address_2": "TOWER 2 SUITE 335A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "972-630-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 NORTH CENTRAL EXPRESSWAY",
            "address_2": "TOWER 2 SUITE 335A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "972-630-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS CLINICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-10",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "VISKOVICH",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "VP OF COMPLIANCE",
        "authorized_official_telephone_number": "972-630-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.