Organization
ARK LA TEX COVID TESTING SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETISHA WILLIAMS (ADMINISTRATOR)
(318) 834-5036
Entity
Organization
Contact information
Practice address
916 MANOR DR, DESOTO, TX 75115-3471
(318) 834-5036
Mailing address
916 MANOR DR, DESOTO, TX 75115-3471
(318) 834-5036
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2248604
CLIA WAIVER
TX
Enumeration date
01/31/2022
Last updated
01/31/2022
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