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General NPI Number Information
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NPI Number | 1619788726
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Entity Type | Organization
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Legal Business Name | HEALIX CLINICAL LABORATORY LLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 4800 FOURNACE PL # BW3
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City | BELLAIRE
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State | TX
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Zip | 77401-2324
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Country | US
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Telephone | 734-673-5917
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Fax | 314-667-6915
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Provider Business Mailing Address
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Address Line | 4800 FOURNACE PL # BW3
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City | BELLAIRE
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State | TX
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Zip | 77401-2324
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Country | US
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Telephone | 734-673-5917
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Fax | 314-667-6915
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | MELANIE MAYCOCK
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Credential |
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Telephone | 734-673-5917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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