Provider Demographics
NPI:1407609209
Name:TOXCODE DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:TOXCODE DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-282-6577
Mailing Address - Street 1:5115 S 122ND EAST AVE STE 202A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-6025
Mailing Address - Country:US
Mailing Address - Phone:918-856-3111
Mailing Address - Fax:
Practice Address - Street 1:5115 S 122ND EAST AVE STE 202A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-6025
Practice Address - Country:US
Practice Address - Phone:918-856-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory