Organization
MBIDX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW T MCCORMICK (OWNER)
(619) 995-1200
Entity
Organization
Contact information
Practice address
1720 REGAL ROW STE 228, DALLAS, TX 75235-2219
(619) 995-1299
(619) 837-2788
Mailing address
1524 VISTA VEREDA, EL CAJON, CA 92019-3808
(619) 995-1200
(619) 837-2788
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/15/2025
Last updated
01/26/2026
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