Organization
DTC LABORATORY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN L WILKINSON M.D. (DIRECTOR)
(601) 484-3257
Entity
Organization
Contact information
Practice address
1512 20TH AVE, MERIDIAN, MS 39301-4124
(601) 484-7740
Mailing address
PO BOX 5869, MERIDIAN, MS 39302-5869
(601) 484-3257
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
25D0651894
MS
Other
Enumeration date
10/18/2006
Last updated
12/07/2012
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