Organization
MCI DIAGNOSTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN PAYNE (COO)
(469) 485-2382
Entity
Organization
Contact information
Practice address
1155 KAS DR STE 180, RICHARDSON, TX 75081-1970
(469) 485-2382
(833) 390-1352
Mailing address
1155 KAS DR STE 180, RICHARDSON, TX 75081-1970
(469) 485-2382
(833) 390-1352
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200031560F
—
OK
Enumeration date
03/11/2019
Last updated
08/22/2022
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