Organization
ELITE LAB SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY DENGLER (PRESIDENT)
(903) 509-3522
Entity
Organization
Contact information
Practice address
2211 ROY ROAD, TYLER, TX 75707-6275
(903) 509-3522
(903) 509-3523
Mailing address
2211 ROY ROAD, TYLER, TX 75707-6275
(903) 509-3522
(903) 509-3523
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D1044325
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176690901
—
TX
Enumeration date
12/16/2005
Last updated
03/14/2011
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