Provider Demographics
NPI:1366238065
Name:MUNICIPAL CLINICAL DX LLC
Entity type:Organization
Organization Name:MUNICIPAL CLINICAL DX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:OVIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-831-5788
Mailing Address - Street 1:1701 N COLLINS BLVD STE 214
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3554
Mailing Address - Country:US
Mailing Address - Phone:214-831-5788
Mailing Address - Fax:214-975-1441
Practice Address - Street 1:1701 N COLLINS BLVD STE 214
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3554
Practice Address - Country:US
Practice Address - Phone:214-831-5788
Practice Address - Fax:214-975-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory