Organization
AXIS PROFESSIONAL LABS LLC
Active
Other names
Kingdom Health Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J GRAY (OFFICER)
(469) 995-7792
Entity
Organization
Contact information
Practice address
4887 ALPHA RD STE 220, FARMERS BRANCH, TX 75244-4632
(469) 995-7792
(469) 995-8238
Mailing address
PO BOX 250989, PLANO, TX 75025-0989
(469) 995-7792
(469) 995-8238
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
37D2122926
OK
Other
Enumeration date
02/03/2017
Last updated
08/29/2022
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