Contract Details
Ancillary Care Services
Facility name
Serolab
Provider ID
P000004699
NPI
1508828773
Tax ID
742083719
Effective Date
4/1/2012
Last Updated
10/31/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
68.00
Location Details
Address
7100 Old McGregor Road Suite A
Waco, TX 76712
United States
County
McLennan
Phone
2547544868 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address