Provider Demographics
NPI:1578978573
Name:PRECISION ANALYSIS LABORATORY, LLC
Entity Type:Organization
Organization Name:PRECISION ANALYSIS LABORATORY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-610-9292
Mailing Address - Street 1:2811 E 15TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5245
Mailing Address - Country:US
Mailing Address - Phone:918-935-3240
Mailing Address - Fax:918-935-3241
Practice Address - Street 1:2811 E 15TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5245
Practice Address - Country:US
Practice Address - Phone:918-935-3240
Practice Address - Fax:918-935-3241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory