Organization
GIBSON DIAGNOSTIC LABS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AZMAT ALI SHAH (OWNER)
(832) 366-7240
Entity
Organization
Contact information
Practice address
813 N O CONNOR RD, IRVING, TX 75061-4510
(855) 890-9589
Mailing address
813 N O CONNOR RD, IRVING, TX 75061-4510
(855) 890-9589
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2095863
TX
Other
Enumeration date
05/19/2015
Last updated
10/05/2018
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