Provider Demographics
NPI:1699191361
Name:TL DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:TL DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-839-9822
Mailing Address - Street 1:1119 W RANDOL MILL RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-6509
Mailing Address - Country:US
Mailing Address - Phone:281-839-9822
Mailing Address - Fax:
Practice Address - Street 1:1119 W RANDOL MILL RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-6509
Practice Address - Country:US
Practice Address - Phone:281-839-9822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory