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General NPI Number Information
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NPI Number | 1710171384
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Entity Type | Organization
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Legal Business Name | CITY CLINICAL LAB
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 6300 HILLCROFT AVE SUITE 100 B
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City | HOUSTON
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State | TX
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Zip | 77081-3005
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Country | US
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Telephone | 718-484-8708
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Fax | 713-484-8799
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Provider Business Mailing Address
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Address Line | 6300 HILLCROFT AVE SUITE 100 B
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City | HOUSTON
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State | TX
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Zip | 77081-3005
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Country | US
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Telephone | 713-771-9994
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Fax | 713-771-9996
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Authorized Official
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Title or Position | LAB.MANAGER/CEO
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Name | MR. ANTHONY AKHIGBE SANAMI
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Credential | BS CHEMISTRY
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Telephone | 713-771-9994
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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 | 45D1044915
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License Number State | TX
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Taxonomy #2
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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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