Organization
DYNAMIC DNA LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AUSTIN DAVID LEE O'REILLY M.S. (OWNER, GENERAL SUPERVISOR)
(417) 861-6723
Entity
Organization
Contact information
Practice address
2144 E REPUBLIC RD, SUITE B204, SPRINGFIELD, MO 65804-4623
(417) 319-1047
(417) 319-7142
Mailing address
2144 E REPUBLIC RD, SUITE B204, SPRINGFIELD, MO 65804-4623
(417) 319-1047
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LC001418393
MO
Other
Enumeration date
01/21/2016
Last updated
04/15/2021
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