Provider Demographics
NPI:1710754304
Name:UNICARE LAB TESTING LLC
Entity Type:Organization
Organization Name:UNICARE LAB TESTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MA
Authorized Official - Prefix:
Authorized Official - First Name:ROSIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-526-1120
Mailing Address - Street 1:108 N PENDELL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4838
Mailing Address - Country:US
Mailing Address - Phone:817-526-1120
Mailing Address - Fax:817-666-1011
Practice Address - Street 1:108 N PENDELL AVE
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4838
Practice Address - Country:US
Practice Address - Phone:817-526-1120
Practice Address - Fax:817-666-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory