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NPI Code Detail

MEDICARE: ELITE CLINICAL LABORATORY, INC

MEDICARE: ELITE CLINICAL 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1215055256
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE CLINICAL LABORATORY, INC
Provider Business Mailing Address
First Line : 3600 S GESSNER RD STE 110
Second Line :
City : HOUSTON
State : TX
Zip : 77063-5149
Country : US
Telephone Number : 281-617-7586
Fax Number :
Provider Business Practice Location Address
First Line : 3600 S GESSNER RD STE 110
Second Line :
City : HOUSTON
State : TX
Zip : 77063-5149
Country : US
Telephone Number : 281-617-7586
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. CHAD HARPER
Credential :
Telephone Number : 832-316-7764
Provider Enumeration Date : 03/27/2007
Last Update Date : 08/10/2023

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Directions to “ELITE CLINICAL LABORATORY, INC ” Practice Location

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