Organization
MEDICLAB CLINICAL LABORATORY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL FASHE (PRESIDENT)
(281) 495-4700
Entity
Organization
Contact information
Practice address
13900 BEECHNUT ST STE D, HOUSTON, TX 77083-6599
(281) 495-4700
(281) 495-4703
Mailing address
13900 BEECHNUT ST STE D, HOUSTON, TX 77083-6599
(281) 495-4700
(281) 495-4703
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2801995
—
TX
Enumeration date
01/21/2010
Last updated
11/26/2011
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