Organization
ABRAXAS SCIENTIFIC
Active
Parent organization
THERAPEUTIC LIFE CHOICES TOHI USTI GVNVNV EDASDI LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THERAPEUTIC LIFE CHOICES TOHI USTI GVNVNV EDASDI LLC
Authorized official
DR. VADIM YEROKHIN PHD (LABORATORY DIRECTOR)
(918) 917-4321
Entity
Organization
Contact information
Practice address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 917-4321
Mailing address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 917-4321
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37D2301589
—
OK
Enumeration date
07/23/2024
Last updated
07/23/2024
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