Organization
KINGDOM HEALTH LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J GRAY (AUTHORIZED OFFICAL)
(469) 995-7795
Entity
Organization
Contact information
Practice address
4887 ALPHA RD STE 205, DALLAS, TX 75244-4632
(469) 995-7851
(469) 995-7851
Mailing address
4887 ALPHA RD STE 205, DALLAS, TX 75244-4632
(469) 995-7851
(469) 995-7851
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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