Provider Demographics
NPI:1235400466
Name:COMMUNITY MEDICAL LABORATORY LLC
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAXTON
Authorized Official - Middle Name:ORAL
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-838-8601
Mailing Address - Street 1:5200 WEST LOOP S
Mailing Address - Street 2:2 ND FLOOR,SUITE 204
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2101
Mailing Address - Country:US
Mailing Address - Phone:713-838-8601
Mailing Address - Fax:713-838-8609
Practice Address - Street 1:5200 WEST LOOP S
Practice Address - Street 2:2 ND FLOOR,SUITE 204
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2101
Practice Address - Country:US
Practice Address - Phone:713-838-8601
Practice Address - Fax:713-838-8609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory