Organization
LAB-VANTAGE, INC
Active
Other names
Lab Vantage
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI ANN KENG (CFO)
(361) 808-9900
Entity
Organization
Contact information
Practice address
510 GORDON ST, CORPUS CHRISTI, TX 78404-2514
(361) 808-9900
(361) 808-9911
Mailing address
510 GORDON ST, CORPUS CHRISTI, TX 78404-2514
(361) 808-9900
(361) 808-9911
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL5096
BCBS #
TX
Enumeration date
05/04/2006
Last updated
08/22/2020
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