Provider Demographics
NPI:1578209946
Name:LABQUEEN DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:LABQUEEN DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMY TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIQUESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RELIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:832-776-8006
Mailing Address - Street 1:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77879-0844
Mailing Address - Country:US
Mailing Address - Phone:832-776-8006
Mailing Address - Fax:
Practice Address - Street 1:259 FLEMING ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:TX
Practice Address - Zip Code:77879-4916
Practice Address - Country:US
Practice Address - Phone:832-776-8006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE5W5X9H9OtherMOBILE PHLEBOTOMY