SAM HOUSTON PARK DIAGNOSTICS, LLC - NPI NUMBER 1750713053

Summary

Provider Name: SAM HOUSTON PARK DIAGNOSTICS, LLC

NPI Number: 1750713053

Clasification: Clinical Medical Laboratory (291U00000X)

Address:
6201 BONHOMME RD
434 S
HOUSTON, TX
ZIP 77036

Phone Number: (713) 975-1151



Detailed Information

SAM HOUSTON PARK DIAGNOSTICS, LLC is a clinical medical laboratory in Houston, TX. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. The assigned NPI number for this provider is 1750713053 and is registered as an organization entity type.

The provider's business address is:

6201 BONHOMME RD
434 S
HOUSTON, TX
ZIP 77036-365
Phone: (713) 975-1151
Fax: (312) 256-9749

The provider's authorized official is Steve Molchanov .
The authorized official title is Owner/president and has the following contact phone number (713) 975-1151.

The enumeration date for this NPI number is 8/8/2013 and was last updated on 10/25/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 291U00000X Clinical Medical Laboratory Yes

NPI Record

No. Field Name Field Value
1 NPI 1750713053
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name SAM HOUSTON PARK DIAGNOSTICS, LLC
5 Provider First Line Business Practice Location Address 6201 BONHOMME RD
6 Provider Second Line Business Practice Location Address 434 S
7 Provider Business Practice Location Address City Name HOUSTON
8 Provider Business Practice Location Address State Name TX
9 Provider Business Practice Location Address Postal Code 770364365
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 7139751151
12 Provider Business Practice Location Address Fax Number 3122569749
13 Provider Enumeration Date 8/8/2013
14 Last Update Date 10/25/2013
15 Authorized Official Last Name MOLCHANOV
16 Authorized Official First Name STEVE
17 Authorized Official Title or Position OWNER/PRESIDENT
18 Authorized Official Telephone Number 7139751151
19 Healthcare Provider Taxonomy Code 1 291U00000X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Name Prefix Text MR.

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.