Organization
LIBERTY LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG BENSON (CONTROLLER)
(214) 377-9845
Entity
Organization
Contact information
Practice address
4316 JAMES CASEY ST, BUILDING F, AUSTIN, TX 78745-1116
(512) 798-0030
(512) 640-8740
Mailing address
PO BOX 702197, DALLAS, TX 75370-2197
(214) 377-9845
(214) 758-0695
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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