Organization
CITY CLINICAL LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY AKHIGBE SANAMI BS CHEMISTRY (LAB.MANAGER/CEO)
(713) 771-9994
Entity
Organization
Contact information
Practice address
6300 HILLCROFT AVE, SUITE 100 B, HOUSTON, TX 77081-3005
(718) 484-8708
(713) 484-8799
Mailing address
6300 HILLCROFT AVE, SUITE 100 B, HOUSTON, TX 77081-3005
(713) 771-9994
(713) 771-9996
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
45D1044915
TX
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01175282
AMERIGROUP NO.
TX
05
—
177274101
—
TX
Enumeration date
08/28/2007
Last updated
09/29/2010
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