Organization
ALIVE DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSELINE BOATENG (OWNER)
(347) 751-8595
Entity
Organization
Contact information
Practice address
2100 N HWY 360 BLDG 4, GRAND PRAIRIE, TX 75050-1011
(972) 961-1119
Mailing address
2100 N HWY 360 BLDG 4, GRAND PRAIRIE, TX 75050-1011
(972) 961-1119
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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