Organization
PATHOS CLINICAL SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESTON BLACK (CEO)
(214) 244-4279
Entity
Organization
Contact information
Practice address
8821 DAVIS BLVD, STE 110, KELLER, TX 76248-0327
(281) 806-9544
Mailing address
8821 DAVIS BLVD, STE 110, KELLER, TX 76248-0327
(281) 806-9544
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2113876
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2113876
CLIA
TX
Enumeration date
12/01/2016
Last updated
09/28/2017
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