Provider Demographics
NPI:1053841023
Name:QUALITY FORENSIC TOXICOLOGY LLC
Entity Type:Organization
Organization Name:QUALITY FORENSIC TOXICOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRIPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-463-9191
Mailing Address - Street 1:4726 SHAVANO OAK STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4029
Mailing Address - Country:US
Mailing Address - Phone:210-463-9191
Mailing Address - Fax:210-463-9190
Practice Address - Street 1:4726 SHAVANO OAK STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4029
Practice Address - Country:US
Practice Address - Phone:210-463-9191
Practice Address - Fax:210-463-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory