Individual provider · Type 1 NPI
Prasad R. Koduru, PhD
Clinical Laboratory Director (Non-physician) · Dallas, TX
NPI number
1508145830
Active
Practice location
6000 Harry Hines Blvd
Dallas, TX 75235-5303
Fax (214) 645-7001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | PKODU1 (NY) |
| Clinical Cytogenetics Physician | 207SC0300X | PKODU1 (NY) |
| Molecular Genetic Pathology (Pathology) Physician | 207ZP0007X | PKODU1 (NY) |
| Clinical Laboratory Director (Non-physician) Primary | 247ZC0005X | None listed |
Clinical Laboratory Director (Non-physician): An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.
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About NPI 1508145830
Prasad R. Koduru, PhD's National Provider Identifier is 1508145830, issued on Aug 4, 2011. The primary taxonomy on file is Clinical Laboratory Director (Non-physician) (247ZC0005X), and the practice location is in Dallas, TX. The record was last updated on Aug 4, 2011.