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General NPI Number Information
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NPI Number | 1689665580
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Entity Type | Organization
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Legal Business Name | LAB SERVICES INC
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 2031 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3222
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Country | US
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Telephone | 956-424-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2031 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3222
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Country | US
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Telephone | 956-424-3000
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RICARDO GAYTAN JR.
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Credential | MT(ASCP) CLS(NCA)
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Telephone | 956-424-3000
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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 | 45D1010460
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License Number State | TX
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