Organization
QUAD CENTRAL LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE GROSS (PRESIDENT)
(903) 445-1265
Entity
Organization
Contact information
Practice address
2630 VILLA DI LAGO UNIT 5, GRAND PRAIRIE, TX 75054-6624
(903) 445-1265
Mailing address
3540 E BROAD ST STE 120, MANSFIELD, TX 76063-5633
(903) 445-1265
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/13/2022
Last updated
01/27/2022
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