Organization
MINERVA LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS WILES (OWNER)
(817) 333-9898
Entity
Organization
Contact information
Practice address
1203 S WHITE CHAPEL BLVD STE 150, SOUTHLAKE, TX 76092-9374
(817) 333-9898
Mailing address
1203 S WHITE CHAPEL BLVD STE 150, SOUTHLAKE, TX 76092-9374
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
03/24/2025
Last updated
03/25/2025
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