# MCI DIAGNOSTIC CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114485042
- **Authorized official:** COLLEEN PAYNE (COO)
- **Authorized official phone:** (469) 485-2382

## Contact information

- **Practice address:** 1155 KAS DR STE 180, RICHARDSON, TX 75081-1970
- **Practice address phone:** (469) 485-2382
- **Practice address fax:** (833) 390-1352
- **Mailing address:** 1155 KAS DR STE 180, RICHARDSON, TX 75081-1970
- **Mailing address phone:** (469) 485-2382
- **Mailing address fax:** (833) 390-1352

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 03/11/2019
- **Last updated:** 08/22/2022