Organization
ONE LAB DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE COATES (MANAGER)
(817) 989-9479
Entity
Organization
Contact information
Practice address
3575 LONE STAR CIR STE 434, FORT WORTH, TX 76177-8908
(817) 989-9479
(817) 989-9478
Mailing address
3575 LONE STAR CIR STE 434, FORT WORTH, TX 76177-8908
(817) 989-9479
(817) 989-9478
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2113785
CLIA
TX
Enumeration date
06/14/2016
Last updated
06/14/2016
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