Provider Demographics
NPI:1487889861
Name:ACU FIRST DIAGNOSTIC LABORATORY, INC
Entity type:Organization
Organization Name:ACU FIRST DIAGNOSTIC LABORATORY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THEOPHILUS
Authorized Official - Middle Name:ENYERIBE
Authorized Official - Last Name:OKORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-631-7600
Mailing Address - Street 1:8204 ELMBROOK DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4067
Mailing Address - Country:US
Mailing Address - Phone:214-631-7600
Mailing Address - Fax:214-631-7601
Practice Address - Street 1:8204 ELMBROOK DR
Practice Address - Street 2:SUITE 108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4067
Practice Address - Country:US
Practice Address - Phone:214-631-7600
Practice Address - Fax:214-631-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory