Healthcare Provider Details

I. General information

NPI: 1720846330
Provider Name (Legal Business Name): SPECIMEN LABWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 EUCLID LOOP
ROSENBERG TX
77469
US

IV. Provider business mailing address

5715 EUCLID LOOP
ROSENBERG TX
77469
US

V. Phone/Fax

Practice location:
  • Phone: 713-779-3258
  • Fax: 832-532-8616
Mailing address:
  • Phone: 713-779-3258
  • Fax: 832-532-8616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. AMBER HASHMI
Title or Position: OWNER
Credential: PHLEBOTOMIST
Phone: 713-779-3258