Organization
MAGNOLIA DIAGNOSTICS, LLC
Active
Parent organization
MAGNOLIA HEALTH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAGNOLIA HEALTH, LLC
Authorized official
JOHN BAINS (PRESIDENT)
(205) 356-6790
Entity
Organization
Contact information
Practice address
4245 N CENTRAL EXPY STE 420, DALLAS, TX 75205-4566
(972) 707-9929
Mailing address
4245 N CENTRAL EXPY STE 420, DALLAS, TX 75205-4566
(205) 356-6790
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/02/2016
Last updated
09/18/2018
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