MEDICARE: SEQ LABORATORY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1003607680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEQ LABORATORY INC

Provider Business Mailing Address
First Line	:	314 W RILEY FUZZEL RD STE 111
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-8396
Country	:	US
Telephone Number	:	346-442-3515
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 W RILEY FUZZEL RD BUILDING 3
Second Line	:	111
City	:	SPRING
State	:	TX
Zip	:	77373-8396
Country	:	US
Telephone Number	:	346-442-3515
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ISHKHAN KHACHATRYAN
Credential	:
Telephone Number	:	346-442-3515

Provider Enumeration Date	:	05/14/2025
Last Update Date	:	05/14/2025

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Directions to “SEQ LABORATORY INC ” Practice Location

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