Provider Demographics
NPI:1376926196
Name:MEDTECH LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:MEDTECH LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BEAU
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-413-9977
Mailing Address - Street 1:11806 BARKER CYPRESS ROAD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:281-664-7001
Mailing Address - Fax:281-664-7004
Practice Address - Street 1:11806 BARKER CYPRESS
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1864
Practice Address - Country:US
Practice Address - Phone:281-664-7001
Practice Address - Fax:281-664-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory