Organization
FACILITATED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIZAR A ALIKHAN (CREDENTIALING CONTACT)
(214) 888-8099
Entity
Organization
Contact information
Practice address
5710 LBJ FREEWAY, SUITE 210, DALLAS, TX 75240
(214) 888-8099
(214) 261-2217
Mailing address
5710 LBJ FREEWAY, SUITE 210, DALLAS, TX 75240
(214) 888-8099
(214) 261-2217
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2110102
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2110102
CLIA
TX
Enumeration date
07/20/2016
Last updated
07/20/2016
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