Provider Demographics
NPI:1053067413
Name:COMMUNITY TESTING CONCIERGE LLC
Entity Type:Organization
Organization Name:COMMUNITY TESTING CONCIERGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOEETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-285-0688
Mailing Address - Street 1:1705 TURTLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2747
Mailing Address - Country:US
Mailing Address - Phone:469-285-0688
Mailing Address - Fax:
Practice Address - Street 1:1705 TURTLE POINT DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2747
Practice Address - Country:US
Practice Address - Phone:469-285-0688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory