Provider Demographics
NPI:1275128993
Name:CELACARE ANALYTICAL SERVICES, LLC
Entity Type:Organization
Organization Name:CELACARE ANALYTICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:817-235-7863
Mailing Address - Street 1:1225 NORTH LOOP W STE 725
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1791
Mailing Address - Country:US
Mailing Address - Phone:817-235-7863
Mailing Address - Fax:
Practice Address - Street 1:800 RAYMOND STOTZER PARKWAY
Practice Address - Street 2:TIPS BLDG 1904, STE 2125
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-4478
Practice Address - Country:US
Practice Address - Phone:361-701-9739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory