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General NPI Number Information
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NPI Number | 1144549635
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Entity Type | Organization
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Legal Business Name | VITA CLINICAL LABORATORY
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 975 CORBINDALE RD SUITE 202
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City | HOUSTON
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State | TX
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Zip | 77024-2818
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Country | US
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Telephone | 281-501-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 975 CORBINDALE RD SUITE 202
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City | HOUSTON
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State | TX
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Zip | 77024-2818
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Country | US
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Telephone | 281-501-8511
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CLINICAL MICROBIOLOGIST
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Name | MISS LETASHA JOY JOSEPH
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Credential | B.S., M(A.S.C.P)
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Telephone | 281-501-8511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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