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SUMMIT CLINICAL LABORATORY LLC NPI 1902425440


NPI Information

NPI: 1902425440
Provider Name: SUMMIT CLINICAL LABORATORY, LLC
Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization

CLIA Number: 03D2114201

Address:
17742 PRESTON RD # 205
DALLAS, TX
ZIP 75252
Phone: (214) 687-2392
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SUMMIT CLINICAL LABORATORY, LLC is a clinical medical laboratory in Dallas, TX. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. SUMMIT CLINICAL LABORATORY, LLC NPI is 1902425440. The provider is registered as an organization entity type.

The provider's business location address is:

17742 PRESTON RD # 205
DALLAS, TX
ZIP 75252-199
Phone: (214) 687-2392
Fax: (214) 602-7003

The provider's authorized official is Oscar Dereva .
The authorized official title is Director and has the following contact phone number (214) 687-2392.

The CLIA number assigned to this NPI record is 03D2114201 - independent with a certificate type of Certificate of Registration.

The enumeration date for this NPI number is 4/14/2020 and was last updated on 9/15/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical LaboratoryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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