Organization
LIGHTHOUSE LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BOURQUE (OWNER)
(972) 242-5388
Entity
Organization
Contact information
Practice address
1735 KELLER SPRINGS RD STE 202, CARROLLTON, TX 75006-3006
(972) 242-5388
Mailing address
1735 KELLER SPRINGS RD, STE 202, CARROLLTON, TX 75006-2962
(972) 242-5388
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2095694
TX
Other
Enumeration date
05/29/2015
Last updated
06/20/2018
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