Organization · Type 2 NPI
Privy Diagnostics Labs, LLC
Clinical Laboratory Director (Non-physician) · Mesquite, TX
Practice location
3224 Gus Thomasson Rd Ste B
Mesquite, TX 75150-4004
Fax (817) 755-0945
Mailing address
1230 N Kimball Ave Ste 130
Southlake, TX 76092-4707
Other practice locations
- 1230 N Kimball Ave Ste 130, Southlake, TX 76092-4707 · (833) 667-7924
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Laboratory Director (Non-physician) Primary | 247ZC0005X | None listed |
| Community Health Clinic/Center | 261QC1500X | None listed |
| Health Service Clinic/Center | 261QH0100X | None listed |
| Infusion Therapy Clinic/Center | 261QI0500X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | None listed |
| Adult Mental Health Clinic/Center | 261QM0850X | None listed |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | None listed |
| Point of Service | 305S00000X | 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.
About NPI 1801542824
Privy Diagnostics Labs, LLC's National Provider Identifier is 1801542824, issued on Feb 28, 2022. The primary taxonomy on file is Clinical Laboratory Director (Non-physician) (247ZC0005X), and the practice location is in Mesquite, TX. The record was last updated on Feb 28, 2022.