Organization
PRASANNA K ATHYALA
Active
Other names
Permian Clinical Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRASANNA KUMAR ATHYALA (MEDICAL LABORATORY DIRECTOR)
(432) 333-1837
Entity
Organization
Contact information
Practice address
415 N JACKSON AVE, ODESSA, TX 79761-5124
(432) 333-1837
(432) 333-1856
Mailing address
415 N JACKSON AVE, ODESSA, TX 79761-5124
(432) 333-1837
(432) 333-1856
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D1020447
TX
Other
Enumeration date
04/03/2007
Last updated
02/23/2010
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