Healthcare Provider Details

I. General information

NPI: 1730555418
Provider Name (Legal Business Name): PHARMONIX LAB, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 WANDO PARK BLVD., SUITE 107
MT. PLEASANT SC
29464
US

IV. Provider business mailing address

10700 STANCLIFF RD
HOUSTON TX
77099-4307
US

V. Phone/Fax

Practice location:
  • Phone: 843-388-5196
  • Fax: 843-388-5332
Mailing address:
  • Phone: 713-333-9323
  • Fax: 832-300-4648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: FAHIM DAYANI
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 713-333-9323