Organization
FORTIS LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON MANIPOL MLS, ASCP (COO/CCO)
(310) 975-4797
Entity
Organization
Contact information
Practice address
1651 N COLLINS BLVD STE 135, RICHARDSON, TX 75080-3658
(469) 530-9050
(469) 530-9051
Mailing address
1651 N COLLINS BLVD STE 135, RICHARDSON, TX 75080-3658
(469) 530-9050
(469) 530-9051
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2098646
TX
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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