MEDICARE: LABTEX DIAGNOSTICS CORPORATION

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	:	1508669516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABTEX DIAGNOSTICS CORPORATION

Provider Business Mailing Address
First Line	:	8303 SOUTHWEST FWY STE 455
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8303 SOUTHWEST FWY STE 455
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1605
Country	:	US
Telephone Number	:	909-556-2644
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANTHONY RICHARDSON
Credential	:
Telephone Number	:	909-556-2644

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/27/2025

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