Provider Demographics
NPI:1568840593
Name:ZENITH LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:ZENITH LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-301-1180
Mailing Address - Street 1:PO BOX 732975
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-2975
Mailing Address - Country:US
Mailing Address - Phone:210-301-1180
Mailing Address - Fax:210-877-9695
Practice Address - Street 1:1212 ALPINE RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5701
Practice Address - Country:US
Practice Address - Phone:903-212-4302
Practice Address - Fax:903-212-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1568840593Medicaid
NJ0532410Medicaid
ID1568840593Medicaid
IA1568840593Medicaid
WA2048327Medicaid
AZ099517Medicaid
VA1568840593Medicaid
GA00316754Medicaid
ME1568840593Medicaid
LA2405934Medicaid
NM51981386Medicaid
MS06123263Medicaid
AL177904Medicaid
KS201124480AMedicaid
AR210177709Medicaid
IN201330240AMedicaid
TX3504649Medicaid
KY7100394590Medicaid
IL89027Medicaid
MO1568840593Medicaid
MT1568840593Medicaid
NH3105679Medicaid
CO94780064Medicaid
NE10026564300Medicaid
OH143289Medicaid
UT1568840593Medicaid
AK1635133Medicaid
OK20061732Medicaid