Provider Demographics
NPI:1790042794
Name:TOXICOLOGY TESTING SERVICE, INC
Entity Type:Organization
Organization Name:TOXICOLOGY TESTING SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-593-2260
Mailing Address - Street 1:5426 NW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4122
Mailing Address - Country:US
Mailing Address - Phone:305-593-2260
Mailing Address - Fax:305-477-6983
Practice Address - Street 1:5426 NW 79TH AVE
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4122
Practice Address - Country:US
Practice Address - Phone:305-593-2260
Practice Address - Fax:305-477-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800001274291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory