Organization
SUNSWET LLC
Active
Other names
SUN DIAGNOSTIC LABORATORY
Organization subpart
No
Provider details
NPI number
Authorized official
PRASANNA ATHYALA (PRESIDENT)
(432) 276-5250
Entity
Organization
Contact information
Practice address
500 ADAMS AVE STE 800, ODESSA, TX 79761-4615
(432) 276-5250
Mailing address
500 ADAMS AVE STE 800, ODESSA, TX 79761-4615
(432) 276-5250
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4502154116
CLIA ID
TX
Enumeration date
11/23/2018
Last updated
02/10/2019
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