Crestar Labs DX LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESTAR LABS DX LLC

Practice address

1651 N Collins Blvd Ste 180
Richardson, TX 75080-3604

Phone

(615) 850-9010

NPI assigned

Oct 15, 2019

Organization subpart

No

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

Authorized official

Name

Fadel Alshalabi

Title

Ceo

Phone

(704) 433-8888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1568004133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 N COLLINS BLVD STE 180",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 N COLLINS BLVD STE 180",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803604",
            "telephone_number": "615-850-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTAR LABS DX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "ALSHALABI",
        "authorized_official_first_name": "FADEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-433-8888"
    },
    "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 Richardson, TX
• Providers in Richardson, 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 15, 2019; 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.