Contract Details
Facility name
Diatherix Laboratories Inc
Provider ID
P000003893
NPI
1134377781
Tax ID
260880495
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
601 Genome Way Suite 4208
Huntsville, AL 35806
United States
County
Madison
Phone
8669794242 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address