MEDICARE: LUMINEX SCOPE LLC

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	:	1295532356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINEX SCOPE LLC

Provider Business Mailing Address
First Line	:	560 W BROWN RD STE 359
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-3221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 SOUTH FWY STE 2395
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76115-1441
Country	:	US
Telephone Number	:	708-334-6353
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAFAE AHMED AKHTAR
Credential	:
Telephone Number	:	708-334-6353

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	04/22/2025

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