Organization
LUCENTA LABORATORY CORP
Active
Other names
Lucenta Laboratory Corp
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARIQ JAVED MOHAMMAD MD (OWNER)
(972) 316-3344
Entity
Organization
Contact information
Practice address
7589 PRESTON RD, SUITE 900, FRISCO, TX 75034-5667
(972) 316-3344
(972) 316-3322
Mailing address
7589 PRESTON RD, SUITE 900, FRISCO, TX 75034-5667
(972) 316-3344
(972) 316-3322
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2018771
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
291U00000X
TAXONOMY
TX
Enumeration date
11/05/2014
Last updated
11/14/2014
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