Healthcare Provider Details

I. General information

NPI: 1619773207
Provider Name (Legal Business Name): ZAGROS CLINICAL LABORATORY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 HIGHWAY 6 S STE 200
HOUSTON TX
77077-1839
US

IV. Provider business mailing address

1505 HIGHWAY 6 S STE 200
HOUSTON TX
77077-1839
US

V. Phone/Fax

Practice location:
  • Phone: 844-543-5888
  • Fax: 832-684-0150
Mailing address:
  • Phone: 844-543-5888
  • Fax: 832-684-0150

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: DR. MEHRAN HAIDARI
Title or Position: OWNER
Credential:
Phone: 844-543-5888