MEDICARE: EQX LABS 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	:	1861157364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EQX LABS LLC

Provider Business Mailing Address
First Line	:	19424 PARK ROW STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-4683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19424 PARK ROW STE 120
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-4683
Country	:	US
Telephone Number	:	832-852-0100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HISHAM ESKARIYAT
Credential	:
Telephone Number	:	832-852-0100

Provider Enumeration Date	:	11/01/2021
Last Update Date	:	01/12/2022

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Directions to “EQX LABS LLC ” Practice Location

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