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General NPI Number Information
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NPI Number | 1275345431
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Entity Type | Organization
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Legal Business Name | ADVANCE TESTING LABORATORY, LLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 5959 WEST LOOP S STE 175
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City | BELLAIRE
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State | TX
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Zip | 77401-1107
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Country | US
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Telephone | 832-461-3148
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Fax |
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Provider Business Mailing Address
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Address Line | 5959 WEST LOOP S STE 175
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City | BELLAIRE
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State | TX
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Zip | 77401-1107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | NAJMUDDIN KHAJA
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Credential |
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Telephone | 832-461-3148
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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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