Organization
PHYSICIAN LABORATORY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NOE ROLANDO MEDINA (CEO)
(956) 380-1281
Entity
Organization
Contact information
Practice address
2015 JACKSON CREEK, EDINBURG, TX 78539
(956) 686-7236
(956) 686-7517
Mailing address
2015 JACKSON CREEK, EDINBURG, TX 78539
(956) 380-1281
(956) 380-1772
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152576801
—
TX
Enumeration date
07/14/2006
Last updated
07/31/2012
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