Provider Demographics
NPI:1013663152
Name:NORTH TEXAS RAPID MOBILE TESTING LLC
Entity Type:Organization
Organization Name:NORTH TEXAS RAPID MOBILE TESTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-908-8385
Mailing Address - Street 1:2817 HOLLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0339
Mailing Address - Country:US
Mailing Address - Phone:214-908-8385
Mailing Address - Fax:
Practice Address - Street 1:2817 HOLLOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0339
Practice Address - Country:US
Practice Address - Phone:214-908-8385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2247227OtherCLIA WAIVER