Organization
LEGACY DIAGNOSTIC LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTHMAN ALBDOUR (OWNER)
(678) 755-9468
Entity
Organization
Contact information
Practice address
1651 N COLLINS BLVD # 135, RICHARDSON, TX 75080-3658
(469) 872-0008
Mailing address
1651 N COLLINS BLVD # 135, RICHARDSON, TX 75080-3658
(469) 872-0008
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
04/12/2021
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