Provider Demographics
NPI:1023886595
Name:SPECTRUM BIO LAB INC
Entity type:Organization
Organization Name:SPECTRUM BIO LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-839-3461
Mailing Address - Street 1:2410 LUNA RD STE 248
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-6578
Mailing Address - Country:US
Mailing Address - Phone:469-930-3690
Mailing Address - Fax:469-935-6877
Practice Address - Street 1:2410 LUNA RD STE 114
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-6536
Practice Address - Country:US
Practice Address - Phone:469-930-3690
Practice Address - Fax:469-935-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory