Organization
SOUTHLAKE DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON STABLES JR. (CEO)
(617) 538-1748
Entity
Organization
Contact information
Practice address
580 COMMERCE ST, SUITE 150, SOUTHLAKE, TX 76092-9155
(817) 421-7414
Mailing address
580 COMMERCE ST STE 150B, SOUTHLAKE, TX 76092-9214
(817) 421-7414
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/23/2014
Last updated
07/22/2021
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