Organization
ALLEGIANT LAB TO CAROLINA DIAGNOSTIC LABS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOJ TYAGI PHD (CEO)
(410) 868-8343
Entity
Organization
Contact information
Practice address
1000 HERITAGE CENTER CIR STE 167, ROUND ROCK, TX 78664-4463
(410) 868-8643
Mailing address
1000 HERITAGE CENTER CIR STE 167, ROUND ROCK, TX 78664-4463
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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