SUMMIT CLINICAL LABORATORY, LLC
NPI 1902425440
Clinical Medical Laboratory in Dallas, TX

Active since April 14, 2020
17742 PRESTON RD # 205, DALLAS, TX 75252(214) 687-2392(214) 602-7003 Get Directions Write a Review

NPPES record last updated: September 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 15, 2020, Apr 14, 2020 (2 updates tracked since 2020).

About Summit Clinical Laboratory, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT CLINICAL LABORATORY, LLC (NPI 1902425440) is a healthcare organization registered as a clinical medical laboratory in Dallas, Texas and active in the NPI registry since April 2020. The organization maintains a secondary practice location in Nashville and lists Oscar Dereva, Director, as its authorized official.

NPPES Registry Identity

NPI1902425440
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameSUMMIT CLINICAL LABORATORY, LLC
Location Address17742 PRESTON RD # 205Dallas, TX 75252-6199
Mailing Address2845 Cascade Cove DrLittle Elm, TX 75068-7607 · (214) 687-2392
Fax(214) 602-7003
Organization SubpartNo
Authorized OfficialOscar DerevaDirector · (214) 687-2392
Enumeration DateApril 14, 2020
Last NPPES UpdateSeptember 15, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2020
NPI 1902425440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition
(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.
17742 PRESTON RD # 205, Dallas, TX 75252

Secondary Practice Location 1

Location 12000 Glen Echo Rd Ste 105Nashville, TN 37215-2857 · Phone (214) 687-2392

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summit Clinical Laboratory, LLC's NPI number?

The NPI number for Summit Clinical Laboratory, LLC is 1902425440. It was assigned to this organization in the NPPES registry on April 14, 2020.

Where is Summit Clinical Laboratory, LLC located?

Summit Clinical Laboratory, LLC is located at 17742 Preston Rd # 205, Dallas, TX 75252. The listed phone number is (214) 687-2392.

What is Summit Clinical Laboratory, LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Summit Clinical Laboratory, LLC was last updated on September 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.