Organization
MIDWEST TOXICOLOGY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS E HIMPLER (CONSULTANT)
(225) 303-1055
Entity
Organization
Contact information
Practice address
777 CRAIG RD, #230, CREVE COEUR, MO 63141-7138
(225) 303-1055
(314) 442-4045
Mailing address
777 CRAIG RD, #230, CREVE COEUR, MO 63141-7138
(225) 303-1055
(314) 442-4045
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
INDEPENDENT CLINICAL LABORATORY
MO
Enumeration date
03/19/2015
Last updated
03/19/2015
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