Diversified Diagnostics

NPI #1073814448 in Southlake, Texas

Provider Information

NPI Number: 1073814448
Entity Type: Organization
Organization Name: Diversified Diagnostics
Primary Specialty: Clinical Medical Laboratory
Enumeration Date: Nov 16, 2010
Last Updated: Nov 16, 2010

Practice Location

Address: 2225 W SOUTHLAKE BLVD
Address 2: SUITE 124
City: Southlake
State: Texas
ZIP Code: 76092-6750
Phone: (817) 879-0962

Authorized Official

Name: MS. TINA M YORK
Title: PRESIDENT
Phone: (817) 879-0962

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinical Medical Laboratory	291U00000X	Primary

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